Provider Demographics
NPI:1679812036
Name:BELL, MIGNON YVETTE (LAADC-CA)
Entity Type:Individual
Prefix:MRS
First Name:MIGNON
Middle Name:YVETTE
Last Name:BELL
Suffix:
Gender:F
Credentials:LAADC-CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-2714
Mailing Address - Country:US
Mailing Address - Phone:909-395-0888
Mailing Address - Fax:
Practice Address - Street 1:812 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-2714
Practice Address - Country:US
Practice Address - Phone:909-395-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB041201094101Y00000X
CALCI11300418101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor