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Individual
DR. MATTHEW RUSSELL
Active
Individual
DR. MATTHEW RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
31637
CA
103TC0700X
Clinical Psychologist
PSB94022429
CA
Other
Enumeration date
10/06/2015
Last updated
07/08/2021
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