Individual provider · Type 1 NPI

Theresa Joanne Russell, CADC-11

Specialist · Pollock Pines, CA

NPI number 1255465530 Active

Practice location

5494 Pony Express Trail
Pollock Pines, CA 95726

Call (530) 664-3758 Map

Fax (530) 644-3782

Mailing address

2173 Danbury Way
Rancho Cordova, CA 95670-2271

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XA8463203 (CA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

6 other providers at this address

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About NPI 1255465530

Theresa Joanne Russell, CADC-11's National Provider Identifier is 1255465530, issued on Mar 16, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Pollock Pines, CA. The record was last updated on Jul 8, 2007.