Healthcare Provider Details

I. General information

NPI: 1689227696
Provider Name (Legal Business Name): CHANDA BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 E 1800 S
KAYSVILLE UT
84037-4029
US

IV. Provider business mailing address

386 E 1800 S
KAYSVILLE UT
84037-4029
US

V. Phone/Fax

Practice location:
  • Phone: 562-537-5617
  • Fax:
Mailing address:
  • Phone: 562-537-5617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-76577
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-21-13141
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: