Russ, Carol

Russ, Carol is an individual health care provider with primary practice located at 1767 Grand Ave Suite 4, Pacific Beach CA 92109-4400. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Russ, Carol can be contacted via phone (858) 755-8206.

Contact Information

Primary practice address
1767 Grand Ave Suite 4 Pacific Beach CA 92109-4400
Phone: (858) 755-8206
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY6070 California

Profile Details

NPI number 1770577991
LBN Legal business name Russ, Carol
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1770577991 NPPES
California Other PSY6070 CLINICAL PSYCHOLOGIST

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