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General NPI Number Information
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NPI Number | 1043690027
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Entity Type | Organization
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Legal Business Name | PORTIA BELL HUME CENTER
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 39465 PASEO PADRE PKWY STE 2100
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City | FREMONT
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State | CA
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Zip | 94538-1624
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Country | US
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Telephone | 510-745-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 3170 OAK RD APT 310
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City | WALNUT CREEK
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State | CA
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Zip | 94597-7730
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Country | US
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Telephone | 510-610-8895
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | DR. ELIZABETH PEARCE
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Credential |
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Telephone | 510-745-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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