Healthcare Provider Details

I. General information

NPI: 1730863176
Provider Name (Legal Business Name): CHLOE BELL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 LAFAYETTE ST STE 105
SANTA CLARA CA
95050-4966
US

IV. Provider business mailing address

PO BOX 31396
WALNUT CREEK CA
94598-8396
US

V. Phone/Fax

Practice location:
  • Phone: 408-293-7767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number304218
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: