Healthcare Provider Details

I. General information

NPI: 1902088925
Provider Name (Legal Business Name): EMILY DIANE BERNARD MA, PSYD, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALPINE DRIVE SUITE A
MERCED CA
95340
US

IV. Provider business mailing address

50 ALPINE DR. SUITE A
MERCED CA
95340
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-1606
  • Fax: 209-722-8064
Mailing address:
  • Phone: 209-383-1606
  • Fax: 209-722-8064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number94028350
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: