Provider Demographics
NPI:1437210390
Name:BERNSTEIN, ROBERT M (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 N PALM AVENUE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2271
Mailing Address - Country:US
Mailing Address - Phone:559-226-5263
Mailing Address - Fax:559-226-6602
Practice Address - Street 1:5151 N PALM AVENUE
Practice Address - Street 2:SUITE 800
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2271
Practice Address - Country:US
Practice Address - Phone:559-226-5263
Practice Address - Fax:559-226-6602
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9397103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL939700Medicare ID - Type Unspecified
NPP000Medicare UPIN