Provider Demographics
NPI:1669041539
Name:BELL, JOSEPH JR
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BELL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4335
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95056-4335
Mailing Address - Country:US
Mailing Address - Phone:408-775-5363
Mailing Address - Fax:
Practice Address - Street 1:24301 SOUTHLAND DR STE 600
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1554
Practice Address - Country:US
Practice Address - Phone:510-988-3183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2023-07-19
Deactivation Date:2023-06-12
Deactivation Code:
Reactivation Date:2023-07-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-1156530OtherJUSTICE SERVICES