Provider Demographics
NPI:1740451616
Name:BELL, JUDITH (MS)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WINGED FOOT DR
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-5947
Mailing Address - Country:US
Mailing Address - Phone:415-883-5600
Mailing Address - Fax:415-883-5544
Practice Address - Street 1:19 WINGED FOOT DR
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-5947
Practice Address - Country:US
Practice Address - Phone:415-883-5600
Practice Address - Fax:415-883-5544
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist