Individual
ANGELA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4225 GREEN AVE, LOS ALAMITOS, CA 90720-3569
(562) 230-3044
Mailing address
1501 HUGHES WAY STE 150, LONG BEACH, CA 90810-1878
(310) 221-6336
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
121106
CA
Other
Enumeration date
10/22/2013
Last updated
05/09/2024
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