Provider Demographics
NPI:1104284975
Name:HARNED, BERNADETTE (PMHNP)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:HARNED
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-0563
Mailing Address - Country:US
Mailing Address - Phone:949-874-2067
Mailing Address - Fax:
Practice Address - Street 1:26400 LA ALAMEDA STE 208
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6307
Practice Address - Country:US
Practice Address - Phone:949-606-4698
Practice Address - Fax:949-215-2529
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95007615363LP0808X
CARN434948163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMH4554867OtherDEA