Jacques Russell
Marriage & Family Therapist in San Francisco, CA. Individual provider (NPI-1).
NPI number1205200078
StatusActive
Last updated in NPPESDec 15, 2016
Details
- NPI
- 1205200078
- Entity type
- Individual (NPI-1)
- Name
- Jacques Russell
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 17, 2015
- Last updated
- Dec 15, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 97144 | CA | Yes |
Practice location
1735 Mission StSan Francisco, CA 94103-2417
Phone 415-762-3700
Mailing address
1735 Mission StSan Francisco, CA 94103-2417
Phone 415-762-3700
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