Healthcare Provider Details

I. General information

NPI: 1225475940
Provider Name (Legal Business Name): DAVID RICHARD BELL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 SPAULDING AVE
BERKELEY CA
94703-1602
US

IV. Provider business mailing address

2224 SPAULDING AVE
BERKELEY CA
94703-1602
US

V. Phone/Fax

Practice location:
  • Phone: 510-848-8854
  • Fax: 510-848-8854
Mailing address:
  • Phone: 510-848-8854
  • Fax: 510-848-8854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS14633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: