Provider Demographics
NPI:1689850562
Name:BERNARDY, LYNETTE JEANINE
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:JEANINE
Last Name:BERNARDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3579 ARLINGTON AVE
Mailing Address - Street 2:STE #200
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3915
Mailing Address - Country:US
Mailing Address - Phone:951-781-6762
Mailing Address - Fax:951-781-6249
Practice Address - Street 1:3579 ARLINGTON AVE
Practice Address - Street 2:STE #200
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3915
Practice Address - Country:US
Practice Address - Phone:951-781-6762
Practice Address - Fax:951-781-6249
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)