Individual
DOUGLAS CHARLES RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1282 MARKET ST, SAN FRANCISCO, CA 94102-4801
(415) 579-3021
Mailing address
1282 MARKET ST, SAN FRANCISCO, CA 94102-4801
(415) 579-3021
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1353500719
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
CA
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
11/03/2021
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