Individual
ANN SARENE RUSSUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3744 MT DIABLO BLVD STE 206, LAFAYETTE, CA 94549-3614
(925) 788-7599
Mailing address
3744 MT DIABLO BLVD STE 206, LAFAYETTE, CA 94549-3614
(925) 788-7599
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
IMF 50843
CA
106H00000X
Marriage & Family Therapist
Primary
MFC51246
CA
Other
Enumeration date
01/31/2007
Last updated
05/14/2020
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