Individual
DEDRA JANENE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RAS
Contact information
Practice address
10620 SCHIRRA AVE, MATHER, CA 95655
(916) 255-7065
Mailing address
PO BOX 38369, SACRAMENTO, CA 95838-0369
(916) 929-1951
(916) 929-5116
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/20/2009
Last updated
08/05/2025
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