# JOHN K. RUSSELL, PH.D. A PSYCHOLOGICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851711881
- **Authorized official:** DR. JOHN KENNETH RUSSELL PH.D (PRESIDENT)
- **Authorized official phone:** (562) 799-3333

## Contact information

- **Practice address:** 1945 PALO VERDE AVENUE, SUITE 202, LONG BEACH, CA 90815-3445
- **Practice address phone:** (562) 799-3333
- **Practice address fax:** (562) 799-3355
- **Mailing address:** 1945 PALO VERDE AVE, SUITE 202, LONG BEACH, CA 90815-3443
- **Mailing address phone:** (562) 799-3333
- **Mailing address fax:** (562) 799-3355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | PSY4430 | CA | Yes |

## Other

- **Enumeration date:** 04/17/2014
- **Last updated:** 04/17/2014