Provider Demographics
NPI:1669835047
Name:BERNS, ADAM MARK (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MARK
Last Name:BERNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DANIEL BURNHAM CT APT 903
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5459
Mailing Address - Country:US
Mailing Address - Phone:516-729-5125
Mailing Address - Fax:
Practice Address - Street 1:2995 WOODSIDE RD STE 300
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:CA
Practice Address - Zip Code:94062-2447
Practice Address - Country:US
Practice Address - Phone:646-369-9039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1671432084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry