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1184777492
RUSSELL S PHILLIPS
STOCKTON, CA
NPI
1184777492
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2007-01-19
Last Update Date
2023-12-21
Business Address
Mr. RUSSELL S PHILLIPS
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-953-5436
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Mailing Address
Mr. RUSSELL S PHILLIPS
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-953-5436
Copy
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