{
"Npi": {
"NPI": "1598994642",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PORTIA BELL HUME BEHAVIORAL HEALTH AND TRAINING CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "39420 LIBERTY ST STE 140",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FREMONT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94538-2289",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-745-9151",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "39420 LIBERTY ST STE 252",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FREMONT",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94538-2297",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-745-9151",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/10/2009",
"LastUpdateDate": "10/28/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIKAND",
"AuthorizedOfficialFirstName": "JOTY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PSY. D.",
"AuthorizedOfficialTelephoneNumber": "510-745-9151",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}