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MR. JEFFREY RAYMOND RUSSELL II
NPI 1942858055
Counselor - Addiction (Substance Use Disorder) in San Pedro, CA

Active since September 01, 2019
1003 S BEACON ST, SAN PEDRO, CA 90731(310) 514-4940 Get Directions Write a Review

NPPES record last updated: August 4, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 30, 2021, Feb 11, 2021 (2 updates tracked since 2021).

About Mr. Jeffrey Raymond Russell Ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JEFFREY RAYMOND RUSSELL II (NPI 1942858055) is an individual addiction (substance use disorder) provider in San Pedro, California and active in the NPI registry since September 2019. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1942858055
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. JEFFREY RAYMOND RUSSELL II
Location Address1003 S BEACON STSan Pedro, CA 90731-4324
Mailing Address3440 Torrance Blvd Ste 104Torrance, CA 90503-5805 · (310) 787-1335 · Fax (310) 787-1809
Phone(310) 514-4940
Sole ProprietorYes
Enumeration DateSeptember 1, 2019
Last NPPES UpdateAugust 4, 20232 updates tracked since enumeration
NPPES CertifiedAugust 4, 2023
✔ NPI 1942858055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
1003 S BEACON ST, San Pedro, CA 90731
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Secondary Practice Locations 2

Location 1132 W 10th StSan Pedro, CA 90731-3702 · Phone (310) 514-4940 ext. 861
Location 2411 W 10th StSan Pedro, CA 90731-3213 · Phone (310) 514-4940

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH D HARRINGTON RADT
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
AARON ROGER CRANDELL
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (310) 868-9583
MARTIN GALLARDO RADT
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
RAYMOND SETH MORENO
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
KYLE VINCENT CONNEALLY
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
MR. JOSEPH TYLER DUGGAN RAC
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
MR. MATTHEW R KEOUGH
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (310) 514-4940
MR. DANDRE JONES
Counselor (Addiction (Substance Use Disorder))
1003 S BEACON ST
SAN PEDRO, CA 90731
Los Angeles County (424) 772-9669

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Russell's NPI number?

The NPI number for Jeffrey Russell is 1942858055. It was assigned to this individual provider in the NPPES registry on September 1, 2019.

Where is Jeffrey Russell located?

Jeffrey Russell practices at 1003 S Beacon St, San Pedro, CA 90731. The listed phone number is (310) 514-4940.

What is Jeffrey Russell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Jeffrey Russell was last updated on August 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.