Individual provider · Type 1 NPI

Jamie D. Russell

Mental Health Counselor · Gardena, CA

NPI number 1043450158 Active

Practice location

130 W Victoria St
Gardena, CA 90248-3523

Mailing address

702 Main St, Unit A
Huntington Beach, CA 92648-3402

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1043450158

Jamie D. Russell's National Provider Identifier is 1043450158, issued on Mar 2, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Gardena, CA. The record was last updated on Mar 2, 2009.