Russel Albert Arnett III, CADC-II, ICADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · San Jacinto, CA

NPI 1508105461 · NPPES record last updated Feb 12, 2013

Key facts

NPI
1508105461
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CERT. # A36984987 (CA)
Practice address
1391 Rojo LN
San Jacinto, CA 92582-4203
Phone
(951) 852-7700
NPI assigned
Feb 12, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CERT. # A36984987CAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CERT. # A36984987 CA Yes

Addresses

Primary practice location

1391 Rojo LN
San Jacinto, CA 92582-4203

Mailing address

1391 Rojo LN
San Jacinto, CA 92582-4203
Phone (951) 852-7700

Other providers in San Jacinto, CA

All providers in San Jacinto, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.