MEDICARE: CHRISTINE BERNET PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY15679	CA
2	103T00000X	Psychologist	PSY15679	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891783288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE BERNET PHD

Provider Business Mailing Address
First Line	:	2031 2ND AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2015
Country	:	US
Telephone Number	:	619-699-8443
Fax Number	:	619-237-9499

Provider Business Practice Location Address
First Line	:	2031 2ND AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2015
Country	:	US
Telephone Number	:	619-699-8443
Fax Number	:	619-237-9499

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	07/30/2015

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Directions to “ CHRISTINE BERNET PHD” Practice Location

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