MEDICARE: PORTIA BELL HUME BEHAVIORAL HEALTH AND TRAINING CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700191236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORTIA BELL HUME BEHAVIORAL HEALTH AND TRAINING CENTER

Provider Business Mailing Address
First Line	:	1333 WILLOW PASS RD
Second Line	:	SUITE 102
City	:	CONCORD
State	:	CA
Zip	:	94520-7930
Country	:	US
Telephone Number	:	925-825-1793
Fax Number	:

Provider Business Practice Location Address
First Line	:	2253 5TH ST
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94550-4549
Country	:	US
Telephone Number	:	925-606-4709
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOTY SIKAND
Credential	:	PSY.D.
Telephone Number	:	925-825-1793

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	04/06/2020

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