LINDA J BERNARDIN (NPI# 1790795128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790795128 |
| Entity Type | Individual |
| Full Name | LINDA J BERNARDIN |
| Credential | PHD |
| Practice Address |
430 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209264200 |
| Practice Fax Number | 9209268885 |
| Mailing Telephone | 9209264200 |
| Mailing Fax Number | 9209268885 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | 2061 | WI | Behavioral Health & Social Service Providers |
| X | 103T00000X | Psychologist | 2061 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39132000 | 05 |
| Street Address |
430 E DIVISION ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157831 | Gilberto Cantu | Nurse Anesthetist, Certified Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2005-07-09 |
| 1992306310 | Leah Timm | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-11-03 |
| 1982212312 | Tiffany M Parker | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-07-22 |
| 1619594355 | Brynn Sytsma | Student in an Organized Health Care Education/Training Program | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-29 |
| 1891312633 | Joshua Mckinney | Counselor | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-27 |
| 1275153264 | Jacalyn Lucille Wendt Coleman | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-04-20 |
| 1568090884 | Jaclyn R Monteverde | Physician Assistant | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-31 |
| 1235766718 | Emily Jean Thiel | Dietitian, Registered | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-25 |
| 1326674136 | Alexandria Lynn Hefter | Nurse Practitioner | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2020-03-13 |
| 1952933046 | Gina Paveglio | Registered Nurse | 430 E Division St, Surgery Dept, Fond Du Lac, WI 54935 | 2020-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891054441 | Mary Christine Majors | Clinical Neuropsychologist | 625 Wildlife Dr, Fond Du Lac, WI 54937-7708 | 2012-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578023156 | Midway Clinical Neuropsychologic Institute and Children's Wellness Fou | Clinical Neuropsychologist | 1024 60th Street, Suite 5, Kenosha, WI 53140-4099 | 2019-03-21 |
| 1114449949 | Tobias D Kaemmerer | Clinical Neuropsychologist | 2901 W Kinnickinnic River Pkwy Ste 417, Milwaukee, WI 53215-3660 | 2017-07-13 |
| 1972989804 | Anne L Shandera-ochsner | Clinical Neuropsychologist | 212 11th Street, La Crosse, WI 54601 | 2015-08-03 |
| 1821360199 | Tiffany M Jacobsen | Clinical Neuropsychologist | 2448 S 102nd St Ste 270, Milwaukee, WI 53227-2147 | 2012-02-02 |
| 1861625220 | Rebecca L Torres | Clinical Neuropsychologist | 721 American Ave Ste 406, Waukesha, WI 53188-5071 | 2009-09-01 |
| 1336319979 | Shellie Dee Locke | Clinical Neuropsychologist | 9020 15th Ave, Kenosha, WI 53143-6803 | 2008-03-11 |
| 1538352935 | Robert George Owens | Clinical Neuropsychologist | 2653 Statdust Trail, Verona, WI 53593-9714 | 2007-08-20 |
| 1720278005 | Judith Davis | Clinical Neuropsychologist | 716 Roby Rd, Stoughton, WI 53589 | 2007-08-01 |
| 1821201930 | Bonita P Klein-tasman | Clinical Neuropsychologist | 2441 E Hartford Ave, Garland 210, Milwaukee, WI 53211-3160 | 2007-05-07 |
| 1659598746 | Christopher Paul Wiebusch | Clinical Neuropsychologist | N27w23953 Paul Rd, Ste. 206, Pewaukee, WI 53072-6242 | 2007-04-19 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.