Provider Demographics
NPI:1255528626
Name:BELL, FELICHA DESIRAEE (RN, PHN)
Entity type:Individual
Prefix:MRS
First Name:FELICHA
Middle Name:DESIRAEE
Last Name:BELL
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 POTRERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2116
Mailing Address - Country:US
Mailing Address - Phone:415-206-6629
Mailing Address - Fax:415-206-6653
Practice Address - Street 1:635 POTRERO AVENUE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2116
Practice Address - Country:US
Practice Address - Phone:415-206-6629
Practice Address - Fax:415-206-6653
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615789163WC0400X
CA66349163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management