Provider Demographics
NPI:1215177381
Name:SEMPELL, RUSSELL HOWARD (MFT)
Entity type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:HOWARD
Last Name:SEMPELL
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10296
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-0296
Mailing Address - Country:US
Mailing Address - Phone:661-831-4706
Mailing Address - Fax:
Practice Address - Street 1:1408 CORTE CANALETTE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7128
Practice Address - Country:US
Practice Address - Phone:661-831-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21849106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist