JEFFREY RAYMOND RUSSELL

SAN PEDRO, CA
NPI1942858055
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-09-01
Last Update Date2023-08-04
Business Address
Mr. JEFFREY RAYMOND RUSSELL
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 310-514-4940
Mailing Address
Mr. JEFFREY RAYMOND RUSSELL
3440 TORRANCE BLVD STE 104
TORRANCE, CA 90503-5805
Phone number: 310-787-1335
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