DR. JOHN KENNETH RUSSELL (NPI# 1407843295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407843295 |
| Entity Type | Individual |
| Full Name | DR. JOHN KENNETH RUSSELL |
| Credential | PH.D. |
| Practice Address |
1945 Palo Verde Ave Suite 202 Long Beach CA 90815-3443 |
| Practice Telephone | 5627993333 |
| Practice Fax Number | 5627993355 |
| Mailing Telephone | 5627993333 |
| Mailing Fax Number | 5627993355 |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2014-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY4430 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FEDERAL TAX ID | 95-3278711 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821231663 | John Russell IIi | Dentist | 206 N Brookmoore Dr, Columbus, MS 39705-2020 | 2009-04-09 |
| 1417106196 | John Edwin Russell | Physical Medicine & Rehabilitation | 6455 Toucan Trl, Spring Hill, FL 34607-2642 | 2008-09-17 |
| 1831221159 | John Clark Russell | Dentist | 2010 Court St, Beatrice, NE 68310-3209 | 2007-03-12 |
| 1811023963 | John Thomas Russell | Dentist | 1116 West St, Suite B, Annapolis, MD 21401-3608 | 2007-02-25 |
| 1003957515 | John Wesley Russell | Dentist | 3253 Mccracken St, Muskegon, MI 49441 | 2007-02-08 |
| 1902958077 | John Douglas Russell | Dentist | 4178 Ashby Court, Shasta Lake City, CA 96019 | 2007-01-17 |
| 1619066156 | John Grover Russell | Specialist | 8188 W Bartlett Rd, Casa Grande, AZ 85222-7336 | 2006-10-12 |
| 1003918137 | John C Russell | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2731 Oak Bluff, San Antonio, TX 78230 | 2006-09-01 |
| 1720013204 | John Russell | Urology | 22 Hartford St # Sr, Houlton, ME 04730-1844 | 2006-07-12 |
| 1619925294 | John Andrew Haws Russell | Obstetrics & Gynecology | 106 Liner Dr, Greenwood, SC 29646 | 2006-05-05 |
| Street Address |
1945 PALO VERDE AVE SUITE 202 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90815-3443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992709950 | California Homecare Pharmacy, Inc. | Home Health | 1945 Palo Verde Ave, Ste 210, Long Beach, CA 90815-3445 | 2005-06-08 |
| 1528409216 | Quantum Eye Group, Inc. | Ophthalmology | 1945 Palo Verde Ave, Suite #210, Long Beach, CA 90815-3445 | 2013-07-10 |
| 1518285360 | Ravi Menghani | Ophthalmology | 1945 Palo Verde Ave, Suite #210, Long Beach, CA 90815-3445 | 2010-05-04 |
| 1902044233 | Barry Tonnis Levy | Marriage & Family Therapist | 1945 Palo Verde Ave, Suite 202, Long Beach, CA 90815-3443 | 2009-01-23 |
| 1609930122 | Anthony Fiore | Psychologist | 1945 Palo Verde Ave, Suite 202, Long Beach, CA 90815-3443 | 2006-12-20 |
| 1982766879 | David Sequeira | Psychologist | 1945 Palo Verde Ave, Suite 202, Long Beach, CA 90815-3443 | 2006-12-15 |
| 1558434431 | Dennis Hui-ting Chen, M.d., Inc. | Anesthesiology | 1945 Palo Verde Ave, Suite #101, Long Beach, CA 90815-3443 | 2006-11-16 |
| 1548368780 | Hans H Freyhardt | Marriage & Family Therapist | 1945 Palo Verde Ave, Suite 202, Long Beach, CA 90815-3443 | 2006-09-20 |
| 1366468290 | William Eugene Adams | Psychologist | 1945 Palo Verde Ave, Suite 204, Long Beach, CA 90815-3443 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316596745 | Fatima A. Hernandez | Technician | 2846 N Greenbrier Road, Long Beach, CA 90815 | 2019-09-09 |
| 1376027938 | Abigail Joy Dominguez | Social Worker | 2725 Hackett Ave, Long Beach, CA 90815 | 2018-09-19 |
| 1790271716 | The North Star Center for Marriage and Family Therapy, Inc. | Counselor | Faith Recovery, 2211 Suite C Palo Verde Ave, Long Beach, CA 90815 | 2018-07-02 |
| 1639600844 | Melissa Suzanne Fitzgerald | Nurse Practitioner | 6510 E. Spring Street, Spring Family Medical Group, Long Beach, CA 90815 | 2017-03-21 |
| 1588102818 | Jeff Clement | Registered Nurse | 1824 Stearnlee Avenue, Long Beach, CA 90815 | 2017-02-07 |
| 1376923524 | Edward Carl Woerz | Surgery | 5640 E. Las Lomas St., L.b., CA 90815 | 2015-06-03 |
| 1558765107 | Kendall Cheney Perez | Social Worker | 4142 E Mendez St Unit 433, Long Beach, CA 90815 | 2014-10-10 |
| 1689087769 | Nellie Grace Bell, Ma, Inc. | Marriage & Family Therapist | 6200 E. Spring St., Suite G, Long Beach, CA 90815 | 2014-06-06 |
| 1245652270 | Nguyen and Ghazal Dental Corporation | Dentist | 5533-a East Stearns Street, Long Beach, CA 90815 | 2014-01-10 |
| 1306267182 | Marcia Freeman | Licensed Practical Nurse | 2250 Grand Ave, Long Beach, CA 90815 | 2013-12-23 |
| Find all providers in zip 90815 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275154791 | Eric Houston | Psychologist | 3906 Hathaway Ave, Long Beach, CA 90815-5125 | 2020-05-06 |
| 1003448218 | Julie Goalwin, Ph.d. A Psychological Corporation | Psychologist | 115 Pine Ave Ste 640, Long Beach, CA 90802-4452 | 2020-02-05 |
| 1730654401 | Nicholas Brown | Psychologist | 5901 E. 7th Street (06/116b), Long Beach, CA 90822 | 2018-10-09 |
| 1194208983 | Tiffany Danielle Sickler | Psychologist | 4201 Long Beach Blvd Ste 409, Long Beach, CA 90807-2022 | 2018-09-08 |
| 1639656036 | Heights Wellness, Inc | Psychologist | 440 Redondo Ave Ste 104, Long Beach, CA 90814-5144 | 2018-07-27 |
| 1386168136 | Shena Young | Psychologist | 404 East First St #1191, Long Beach, CA 90802 | 2017-08-02 |
| 1699135558 | Margo Frost Watson | Psychologist | 270 San Remo Dr, Long Beach, CA 90803-3620 | 2016-03-04 |
| 1336506997 | Heights Center for Counseling and Wellness, Inc | Psychologist | 440 Redondo Ave Ste 103, Long Beach, CA 90814-5143 | 2016-01-26 |
| 1619373008 | Corina Reyes Lopez | Psychologist | 5901 E 7th St # 6116b, Long Beach, CA 90822-5201 | 2014-11-12 |
| 1841695129 | Sherri Nielsen | Psychologist | 1539 Harbor Ave, Long Beach, CA 90813-1322 | 2014-10-28 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90815 |
Please comment or provide details below to improve the information on DR. JOHN KENNETH RUSSELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.