Doctor Name: | STEPHANIE RUSSO |
NPI Number: | 1699904730 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 13950 Milton Ave Ste 306 Westminster, CA - 926832939 |
Business Phone Number: | 7143794484 |
Business Fax Number: | |
Mailing Address: | Po Box 16513, IRVINE |
State: | CA |
Postal Code: | 926236513 |
Phone Number: | 9492304513 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2009 |
NPI Last Update Date: | 07/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |