Organization
JOHN K. RUSSELL, PH.D. A PSYCHOLOGICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KENNETH RUSSELL PH.D (PRESIDENT)
(562) 799-3333
Entity
Organization
Contact information
Practice address
1945 PALO VERDE AVENUE, SUITE 202, LONG BEACH, CA 90815-3445
(562) 799-3333
(562) 799-3355
Mailing address
1945 PALO VERDE AVE, SUITE 202, LONG BEACH, CA 90815-3443
(562) 799-3333
(562) 799-3355
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
PSY4430
CA
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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