Russell, Samantha Jo
Russell, Samantha Jo is an sole proprietor health care provider with primary practice located at 1904 Richland Ave Bldg A , Ceres CA 95307-4562. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Russell, Samantha Jo can be contacted via phone (209) 543-0440.Contact Information
Primary practice address
1904 Richland Ave Bldg A
Ceres CA 95307-4562
Phone: (209) 543-0440
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 107583 | California |
Profile Details
| NPI number | 1467832824 |
|---|---|
| LBN Legal business name | Russell, Samantha Jo |
| Credentials | Marriage and Family Therapist (MFT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2015 |
| Last updated | Aug 28th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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