Individual provider Active NPI

Christine Bernet, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1891783288
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15679 Issued in CA
Practice address
2031 2ND Ave
San Diego, CA 92101-2015
Phone
(619) 699-8443
Fax
(619) 237-9499
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY15679 CA Primary
Psychologist 103T00000X PSY15679 CA

Addresses

Primary practice location

2031 2ND Ave
San Diego, CA 92101-2015

Mailing address

2031 2ND Ave
San Diego, CA 92101-2015
Phone (619) 699-8443

Other identifiers 1

IdentifierTypeStateIssuer
PSY15679MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY15679CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1891783288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 2ND AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012015",
            "telephone_number": "619-699-8443",
            "fax_number": "619-237-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 2ND AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012015",
            "telephone_number": "619-699-8443",
            "fax_number": "619-237-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNET",
        "first_name": "CHRISTINE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15679",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY15679",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY15679",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.