Individual
BRANDON TIMOTHY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2403 PROFESSIONAL DR, SANTA ROSA, CA 95403-3007
(707) 544-3295
Mailing address
8571 BRAND LN, PENNGROVE, CA 94951-8708
(707) 241-5630
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
06/11/2025
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