Provider Demographics
NPI:1508105461
Name:ARNETT, RUSSEL ALBERT III (CADC-II, ICADC)
Entity Type:Individual
Prefix:PROF
First Name:RUSSEL
Middle Name:ALBERT
Last Name:ARNETT
Suffix:III
Gender:M
Credentials:CADC-II, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 ROJO LN
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-4203
Mailing Address - Country:US
Mailing Address - Phone:951-852-7700
Mailing Address - Fax:
Practice Address - Street 1:1391 ROJO LN
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-4203
Practice Address - Country:US
Practice Address - Phone:951-852-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACERT. # A36984987101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)