Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | CA | |
Y | 103T00000X | Psychologist | CA |
NPI | 1013497999 |
---|---|
Provider Name | Jorge Bell |
First Address | Walnut Creek, CA 94598-2460 |
Second Address | Walnut Creek, CA 94598-2460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2018 |
Last Update Date | 11/02/2020 |