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General NPI Number Information
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NPI Number | 1346546173
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Entity Type | Individual
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Provider Name | DR. BERT HILDAN EPSTEIN
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Gender | Male
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 115 LIBERTY ST STE 5
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City | PETALUMA
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State | CA
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Zip | 94952-2320
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Country | US
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Telephone | 707-242-1989
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Fax |
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Provider Business Mailing Address
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Address Line | 45 ADAMS LN
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City | PETALUMA
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State | CA
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Zip | 94952-4766
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Country | US
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Telephone | 916-709-6899
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY21404
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY21404
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY21404
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License Number State | CA
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