Individual provider · Type 1 NPI

Tajah Russell

Student in an Organized Health Care Education/Training Program · Pasadena, CA

NPI number 1609376078 Active

Practice location

940 Avenue 64
Pasadena, CA 91105-2711

Call (323) 543-2800 Map

Fax (323) 978-1263

Specialties and licenses

TaxonomyCodeLicense
Behavior Technician 106S00000X000004000 (CA)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1609376078

Tajah Russell's National Provider Identifier is 1609376078, issued on Feb 12, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Pasadena, CA. The record was last updated on Oct 15, 2019.