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1104665124
JAQUEESE RUSSELL
OAKLAND, CA
NPI
1104665124
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-05-20
Last Update Date
2024-06-27
Business Address
JAQUEESE RUSSELL
390 40TH ST
OAKLAND, CA 94609-2633
Phone number: 510-899-0128
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Mailing Address
JAQUEESE RUSSELL
390 40TH ST
OAKLAND, CA 94609-2633
Phone number: 510-899-0128
Copy
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