Provider Demographics
NPI:1740150192
Name:BELL, VINCENT JAMAL
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:JAMAL
Last Name:BELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:VINCE
Other - Middle Name:JAMAL
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1883 CHERRYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-2601
Mailing Address - Country:US
Mailing Address - Phone:408-230-6525
Mailing Address - Fax:
Practice Address - Street 1:1883 CHERRYWOOD PL
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-2601
Practice Address - Country:US
Practice Address - Phone:408-230-6525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician