Individual
ALECIA NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
999 S FAIRMONT AVE, STE. 230, LODI, CA 95240-5100
(209) 334-4924
(209) 334-0127
Mailing address
PO BOX 1090, LODI, CA 95241-1090
(209) 334-1800
(209) 334-2416
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20A14816
CA
Other
Enumeration date
05/16/2012
Last updated
09/16/2022
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