| Doctor Name: | MRS. NANCY DEACON RUSSELL |
| NPI Number: | 1598887853 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 802 |
| Business Practice Address: | 1030 S Arroyo Pkwy Suite #109 Pasadena, CA - 911053214 |
| Business Phone Number: | 6265932283 |
| Business Fax Number: | 6265932284 |
| Mailing Address: | 1621 Glyndon Ave, VENICE |
| State: | CA |
| Postal Code: | 902912923 |
| Phone Number: | 3109935298 |
| Fax Number: | |
| NPI Enumeration Date: | 04/05/2007 |
| NPI Last Update Date: | 04/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 802 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |