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1104648534
ERIC BERNARD RUSSELL
MORENO VALLEY, CA
NPI
1104648534
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
Additional Taxonomies
104100000X Social Worker
(Licence: CA 126347)
Enumeration Date
2024-10-28
Last Update Date
2025-01-03
Business Address
ERIC BERNARD RUSSELL
15740 TURNBERRY ST
MORENO VALLEY, CA 92555-4903
Phone number: 951-363-8449
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Mailing Address
ERIC BERNARD RUSSELL
5870 ARLINGTON AVE
RIVERSIDE, CA 92504-2037
Phone number: 951-683-6596
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