Healthcare Provider Details

I. General information

NPI: 1609669472
Provider Name (Legal Business Name): CYD BERNSTEIN ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 05/26/2025
Certification Date: 05/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13500 AIRPORT RD
BOONVILLE CA
95415-9133
US

IV. Provider business mailing address

PO BOX 225
YORKVILLE CA
95494-0225
US

V. Phone/Fax

Practice location:
  • Phone: 707-895-3477
  • Fax: 707-895-2035
Mailing address:
  • Phone: 707-367-1831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW116440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: