Provider Demographics
NPI:1568711216
Name:DR. BERNHARDT & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DR. BERNHARDT & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERNHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:818-720-3744
Mailing Address - Street 1:6248 REID ST
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2945
Mailing Address - Country:US
Mailing Address - Phone:818-957-7951
Mailing Address - Fax:818-279-0516
Practice Address - Street 1:750 TERRADO PLZ STE 105
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3411
Practice Address - Country:US
Practice Address - Phone:626-332-9500
Practice Address - Fax:818-279-0516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CERTIF # 1-003-1089251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health