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1861740102
JAMES DOUGLAS RUSSELL
SANTA CRUZ, CA
NPI
1861740102
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA IMF 64743)
Enumeration Date
2012-08-16
Last Update Date
2014-03-07
Business Address
-- JAMES DOUGLAS RUSSELL MFTI
542 OCEAN ST
SANTA CRUZ, CA 95060-6622
Phone number: 831-459-0444
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Mailing Address
-- JAMES DOUGLAS RUSSELL MFTI
PO BOX 1268
CAPITOLA, CA 95010-1268
Phone number: 831-204-0232
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