Individual
CARMEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 LANKERSHIM BLVD. STE. 170, NORTH HOLLYWOOD, CA 90161-2505
(818) 980-3200
Mailing address
6601 VICTORIA AVE APT B206, HIGHLAND, CA 92346-2359
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/27/2009
Last updated
05/13/2013
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