Provider Demographics
NPI:1013739853
Name:RUSS, BELINDA D
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:D
Last Name:RUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7451 RUSH RIVER DR APT 9
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5247
Mailing Address - Country:US
Mailing Address - Phone:314-814-2484
Mailing Address - Fax:
Practice Address - Street 1:7451 RUSH RIVER DR APT 9
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5247
Practice Address - Country:US
Practice Address - Phone:314-814-2484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker