Provider Demographics
NPI:1629594254
Name:BELL, CHARLOTTE VICTORIA (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:VICTORIA
Last Name:BELL
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 HAMILTON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2583
Mailing Address - Country:US
Mailing Address - Phone:919-758-5339
Mailing Address - Fax:
Practice Address - Street 1:2262 HARVARD ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1351
Practice Address - Country:US
Practice Address - Phone:919-758-5339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ1-14-17740103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty