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NPI Code Detail

MEDICARE: DR. CHRISTAL BERNOUS PH.D.

MEDICARE:  DR. CHRISTAL  BERNOUS  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY14682CA

General Provider Information

NPI Number : 1205026077
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTAL BERNOUS PH.D.
Provider Business Mailing Address
First Line : 1451 QUAIL ST
Second Line : SUITE 102
City : NEWPORT BEACH
State : CA
Zip : 92660-2742
Country : US
Telephone Number : 714-345-7235
Fax Number :
Provider Business Practice Location Address
First Line : 1451 QUAIL ST
Second Line : SUITE 102
City : NEWPORT BEACH
State : CA
Zip : 92660-2742
Country : US
Telephone Number : 714-345-7235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2007
Last Update Date : 02/22/2016

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Directions to “ DR. CHRISTAL BERNOUS PH.D.” Practice Location

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