Provider Demographics
NPI:1063433183
Name:NATELSON, BERNARD FRANKLIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:FRANKLIN
Last Name:NATELSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 TERMINO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-6149
Mailing Address - Country:US
Mailing Address - Phone:562-818-1258
Mailing Address - Fax:562-594-4676
Practice Address - Street 1:10900 LOS ALAMITOS BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2354
Practice Address - Country:US
Practice Address - Phone:562-818-1258
Practice Address - Fax:562-594-4676
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 6745103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical