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NPI 1780160978

NPI 1780160978 : LYLA BELLI : SAN LEANDRO, CA

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General NPI Number Information
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    NPI Number           |    1780160978
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    Entity Type          |    Individual 
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    Provider Name        |    LYLA BELLI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/11/2018
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    Last Update Date     |    07/11/2018
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Provider Practice Location Address
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    Address Line         |    2255 BANCROFT AVE 
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    City                 |    SAN LEANDRO
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    State                |    CA
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    Zip                  |    94577-6107
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    Country              |    US
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    Telephone            |    510-618-4400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3691 SWALLOW CT 
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    City                 |    CASTRO VALLEY
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    State                |    CA
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    Zip                  |    94546-3060
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    Country              |    US
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    Telephone            |    925-209-8444
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TS0200X
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    Taxonomy Name        |    School Psychologist
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    License Number       |    170261086
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    License Number State |    CA
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