Provider Demographics
NPI:1821304502
Name:BELL, THOMAS EDWARD (MFT 9160)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:BELL
Suffix:
Gender:M
Credentials:MFT 9160
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 B STREET
Mailing Address - Street 2:STE. 1110
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101
Mailing Address - Country:US
Mailing Address - Phone:714-273-2780
Mailing Address - Fax:858-759-5198
Practice Address - Street 1:701 B STREET
Practice Address - Street 2:STE 1110
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101
Practice Address - Country:US
Practice Address - Phone:714-273-2780
Practice Address - Fax:858-759-5198
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC9160106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
22211438OtherBLUE CROSS
215540OtherMHN