1609159854 NPI number — MISS GAIL ELAINE BERNSTEIN PMHNP

Table of content: MISS GAIL ELAINE BERNSTEIN PMHNP (NPI 1609159854)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609159854 NPI number — MISS GAIL ELAINE BERNSTEIN PMHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERNSTEIN
Provider First Name:
GAIL
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
PMHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609159854
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3835 N FREEWAY BLVD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95834-1954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-576-7900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12865 POINTE DEL MAR WAY STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEL MAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92014-3860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-501-1004
Provider Business Practice Location Address Fax Number:
858-794-7218
Provider Enumeration Date:
09/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  20923 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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