Provider Demographics
NPI:1265642268
Name:BERNHOFT, FRANKLIN OTTO (PHD)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:OTTO
Last Name:BERNHOFT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W KETTLEMAN LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-4334
Mailing Address - Country:US
Mailing Address - Phone:209-366-1516
Mailing Address - Fax:209-366-1516
Practice Address - Street 1:2000 W KETTLEMAN LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-4334
Practice Address - Country:US
Practice Address - Phone:209-366-1516
Practice Address - Fax:209-366-1516
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15240103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling