Healthcare Provider Details

I. General information

NPI: 1992422505
Provider Name (Legal Business Name): LILY BERNHEIMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 HEARST AVE
BERKELEY CA
94709-1319
US

IV. Provider business mailing address

1470 MARIA LN STE 460
WALNUT CREEK CA
94596-5339
US

V. Phone/Fax

Practice location:
  • Phone: 510-526-6200
  • Fax:
Mailing address:
  • Phone: 510-306-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number143407
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: