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Ms. Theresa Joanne Russell, CADC-11
Specialist in Pollock Pines, California
NPI 1255465530

Theresa Joanne Russell is a Specialist based in Rancho Cordova, CA. Theresa Joanne Russell practices in Pollock Pines, CA and has the professional credentials of CADC-11. The NPI Number for Theresa Joanne Russell is 1255465530 and holds a License No. A8463203 (California).

The current practice location address for Theresa Joanne Russell is 5494 Pony Express Trail, Pollock Pines, CA and can be reached out via phone at 530-664-3758 and via fax at 530-644-3782.

Location: 5494 Pony Express Trail, Pollock Pines, CA, 95670-2271
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255465530
Provider Name
Theresa Joanne Russell
Credential
CADC-11
Provider Entity Type
Individual
Gender
Female
Address
5494 Pony Express Trail, Pollock Pines, CA, 95670-2271
Phone Number
530-664-3758
Fax Number
530-644-3782
Provider Enumeration Date
03/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
A8463203 01 CA CADC-11
institution
Provider Business Practice Location Address Details
Address
5494 Pony Express Trail
City
Pollock Pines
State
California
Zip
95726
Phone Number
530-664-3758
Fax Number
530-644-3782
person
Provider Business Mailing Address Details
Address
5494 Pony Express Trail
City
Pollock Pines
State
California
Zip
95726
Phone Number
530-664-3758
Fax Number
530-644-3782
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
A8463203 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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