Basic Information
| Provider Information | |||||||||
| NPI: | 1902115751 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERNSTINE | ||||||||
| FirstName: | ALVIN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2551 SAN PABLO AVE | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946121159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104667142 | ||||||||
| FaxNumber: | 5104512869 | ||||||||
| Practice Location | |||||||||
| Address1: | 2551 SAN PABLO AVE | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946121159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104667142 | ||||||||
| FaxNumber: | 5104512869 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2010 | ||||||||
| LastUpdateDate: | 09/28/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.