| Doctor Name: | DR. BEHROOZ BERNOUS |
| NPI Number: | 1033140991 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PSY10831 |
| Business Practice Address: | 1101 Dove St Suite 165 Newport Beach, CA - 926602839 |
| Business Phone Number: | 9496370730 |
| Business Fax Number: | 9492510313 |
| Mailing Address: | 1101 Dove Street, Suite 165 NEWPORT BEACH |
| State: | CA |
| Postal Code: | 92660 |
| Phone Number: | 9496370730 |
| Fax Number: | 9492510313 |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 09/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY10831 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |