Individual provider · Type 1 NPI
Brandon Timothy Russell
Addiction (Substance Use Disorder) Counselor · Santa Rosa, CA
NPI number
1538053848
Active
Practice location
2403 Professional Dr
Santa Rosa, CA 95403-3007
Mailing address
8571 Brand Ln
Penngrove, CA 94951-8708
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1538053848
Brandon Timothy Russell's National Provider Identifier is 1538053848, issued on Jun 3, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Santa Rosa, CA. The record was last updated on Jun 11, 2025.