Individual
PAUL RUSSELL OSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4065 3RD AVE STE 223, SAN DIEGO, CA 92103-2184
(619) 515-2446
(619) 269-0674
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300
(619) 269-0674
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCC12712
CA
106H00000X
Marriage & Family Therapist
101075
CA
Other
Enumeration date
03/11/2020
Last updated
10/25/2024
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