Individual provider · Type 1 NPI
Ryan J. Russell
Psychiatric/Mental Health Registered Nurse · Glendale, CA
NPI number
1154963114
Active
Practice location
1509 Wilson Ter
Glendale, CA 91206-4007
Mailing address
224 E Dixon St
Azusa, CA 91702-4907
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Registered Nurse Primary | 163WP0808X | 783097 (CA) |
Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1154963114
Ryan J. Russell's National Provider Identifier is 1154963114, issued on Oct 11, 2019. The primary taxonomy on file is Psychiatric/Mental Health Registered Nurse (163WP0808X), and the practice location is in Glendale, CA. The record was last updated on Oct 11, 2019.