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General NPI Number Information
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NPI Number | 1164439600
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Entity Type | Individual
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Provider Name | WILLIAM MORRIS BERNSTEIN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 1435 S SAINT FRANCIS DR BLDG SUITE209
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City | SANTA FE
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State | NM
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Zip | 87505-4202
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Country | US
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Telephone | 505-977-4523
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Fax | 505-503-7897
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Provider Business Mailing Address
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Address Line | 1435 S SAINT FRANCIS DR BLDG SUITE209
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City | SANTA FE
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State | NM
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Zip | 87505-4202
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Country | US
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Telephone | 505-977-4523
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Fax | 505-503-7897
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0882
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 0012C
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License Number State | NM
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