Jesse Russell
Jesse Russell is a Licensed Psychiatric Technician in Orange, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2022
Practice location Address checks out
401 S Tustin St Bldg DOrange, CA 92866-2550
Phone: (714) 289-3936
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Specialties & licences
| Licensed Psychiatric Technician (primary) | Taxonomy 167G00000X · Licence PT24890 (CA) |
|---|
Record details
| NPI number | 1568197655 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 21, 2022 |
| Last updated in NPPES | July 21, 2022 |
| Certification date | July 20, 2022 |
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