John Kenneth Russell in Long Beach - Clinical
John Kenneth Russell - NPI 1407843295
John Kenneth Russell is a Clinical in Long Beach, California. John Kenneth Russell practices all healthcare services and medical treatments related to Clinical. The NPI Number for John Kenneth Russell is 1407843295. The last update date is 2014-04-17.
John Kenneth Russell's current location address is 1945 Palo Verde Ave, Long Beach, California. You can contact this provider via phone number 5627993333 and fax number 5627993355. The mailing address for John Kenneth Russell is 1945 Palo Verde Ave, Long Beach, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Kenneth Russell |
|---|---|
| Address | 1945 Palo Verde Ave, Long Beach, California |
| Phone Number | 5627993333 |
| Fax Number | 5627993355 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1407843295 |
|---|---|
| Provider Enumeration Date | 2005-10-05 |
| Last Updated Date | 2014-04-17 |
Provider Mailing Address Detail
| Address | 1945 Palo Verde Ave |
|---|---|
| City | Long Beach |
| State | California (CA) |
| Post Code | 908153443 |
| Phone Number | 5627993333 |
| Fax Number | 5627993355 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY4430 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 95-3278711 | CA | FEDERAL TAX ID |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to John Kenneth Russell by the Centers for Medicare & Medicaid Services?
The John Kenneth Russell has been issued the NPI (National Provider Identifier) 1407843295 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where John Kenneth Russell is physically located?
The John Kenneth Russell is physically situated at the following address: 1945 Palo Verde Ave, Long Beach, CA, 908153443.
What is the John Kenneth Russell's specialty and taxonomy code?
The John Kenneth Russell's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did John Kenneth Russell receive its 1407843295 assignment from the Centers for Medicare & Medicaid Services?
The John Kenneth Russell was assigned its 1407843295 on 2005-10-05, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding John Kenneth Russell, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to John Kenneth Russell, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2014-04-17.
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