Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jeffrey Raymond Russell II

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1942858055

Mr. Jeffrey Raymond Russell II is an Addiction (Substance Use Disorder) Counselor in San Pedro, California. Practices as a sole proprietor and works from 3 locations. Licensed in California.

Licensed in
CA
In the registry since
2019
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Practice location Address checks out

1003 S Beacon St
San Pedro, CA 90731-4324
Phone: (310) 514-4940
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 411 W 10th St, San Pedro, CA 90731-3213 — (310) 514-4940
  • 132 W 10th St, San Pedro, CA 90731-3702 — (310) 514-4940

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X (CA)

Record details

NPI number1942858055
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 1, 2019
Last updated in NPPESAugust 4, 2023
Certification dateAugust 4, 2023

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