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General NPI Number Information
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NPI Number | 1386843688
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Entity Type | Individual
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Provider Name | RUSSELL ERIC HENDLIN MA, LMFT
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 412 RED HILL AVE STE 17
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City | SAN ANSELMO
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State | CA
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Zip | 94960-2443
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Country | US
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Telephone | 415-233-0788
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 189
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City | SAN GERONIMO
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State | CA
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Zip | 94963-0189
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Country | US
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Telephone | 415-233-0788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 25562
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License Number State | CA
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