=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023610193
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN BELL PH.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2020
-----------------------------------------------------
Last Update Date | 11/12/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 999 N TUSTIN AVE STE 201
-----------------------------------------------------
City | SANTA ANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92705-6506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-975-7950
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 28 LA SOLITA
-----------------------------------------------------
City | FOOTHILL RANCH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92610-1736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TH0004X
-----------------------------------------------------
Taxonomy Name | Health Psychologist
-----------------------------------------------------
License Number | PSY16453
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------