Provider Demographics
NPI:1538627559
Name:BERNOUS PSYCHOLOGICAL SERVICES INC
Entity type:Organization
Organization Name:BERNOUS PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNOUS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-679-4000
Mailing Address - Street 1:1451 QUAIL ST STE 102
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2747
Mailing Address - Country:US
Mailing Address - Phone:949-679-4000
Mailing Address - Fax:949-679-4028
Practice Address - Street 1:1451 QUAIL ST STE 102
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2747
Practice Address - Country:US
Practice Address - Phone:949-679-4000
Practice Address - Fax:949-679-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty