Bernadette Catherine McDonnell, PT, LCCE

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT9797 Issued in CA

Practice address

840 Haverford Ave
#7
Pacific Palisades, CA 90272-4378

Phone

(323) 464-4458

NPI assigned

May 23, 2006

Last updated

Jan 4, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1316992100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 HAVERFORD AVE",
            "address_2": "#7",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724378",
            "telephone_number": "310-459-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HAVERFORD AVE",
            "address_2": "#7",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724378",
            "telephone_number": "323-464-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "BERNADETTE",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "PT, LCCE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT9797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT9797A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark R Sawusch MD Inc
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• Tracy G Marsh, PH.D.
• Max Moncayo DDS Dental Corporation (Palisades Surgical Arts)
• Darby McCullough
• Danielle McLellan-Bujnak, ICPD
• Krystyna McNicoll, MD
• Joanne Gail Mednick, MFT
• Miriam Anne Meyer, MSW
• Carol Lynn Meylan, LCSW

• Physical Therapist in Pacific Palisades, CA
• Providers in Pacific Palisades, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.