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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X IMF 85835 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 Jun 19th, 2024 - about 6 months 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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