Provider Demographics
NPI:1255456943
Name:BERNARD, ALEXIS (AMFT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10850 GOLD CENTER DR STE 325
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6177
Mailing Address - Country:US
Mailing Address - Phone:916-364-8395
Mailing Address - Fax:916-504-4348
Practice Address - Street 1:10850 GOLD CENTER DR STE 325
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6177
Practice Address - Country:US
Practice Address - Phone:916-643-8395
Practice Address - Fax:916-504-4348
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA132622106H00000X
CA63064106H00000X
CA92866106H00000X
CA336410106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor