Individual provider Active NPI

Andrea Bernard, PHD

  • Mental Health Counselor
  • Carlsbad, CA
National Provider Identifier
1306934153
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PSY13143 Issued in CA
Practice address
2541 State St
Suite 210
Carlsbad, CA 92008-1678
Phone
(760) 815-8682
Fax
(760) 634-5500
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PSY13143 CA Primary

Addresses

Primary practice location

2541 State St
Suite 210
Carlsbad, CA 92008-1678

Mailing address

2541 State St
Suite 210
Carlsbad, CA 92008-1678
Phone (760) 815-8682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031215000486 CA Practitioner - Clinical Psychologist 7113824509 Practice locations: Carlsbad, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2011 Palomar Airport Rd
Suite 205
Carlsbad, CA 92011-1431
Phone (760) 815-8682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306934153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 STATE ST",
            "address_2": "SUITE 210",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081678",
            "telephone_number": "760-815-8682",
            "fax_number": "760-634-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2541 STATE ST",
            "address_2": "SUITE 210",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081678",
            "telephone_number": "760-815-8682",
            "fax_number": "760-634-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "ANDREA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSY13143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.