Provider Demographics
NPI:1104457878
Name:BELL, TAMICHA CHARMAINE
Entity type:Individual
Prefix:
First Name:TAMICHA
Middle Name:CHARMAINE
Last Name:BELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13585 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3863
Mailing Address - Country:US
Mailing Address - Phone:510-942-4700
Mailing Address - Fax:
Practice Address - Street 1:13585 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-3863
Practice Address - Country:US
Practice Address - Phone:510-942-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1344820419101YA0400X
CA171M00000X, 373H00000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker