DAVID JOSEPH RUSSELL (NPI# 1477167666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477167666 |
| Entity Type | Individual |
| Full Name | DAVID JOSEPH RUSSELL |
| Credential | PMHNP |
| Practice Address |
17846 Glenwood Rd Manteca CA 95336-9521 |
| Practice Telephone | 6502744324 |
| Mailing Telephone | 6502744324 |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95039943 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407234172 | David Lee Russell Jr. | Counselor | 60 Comstock Ave, Providence, RI 02907-1206 | 2015-05-13 |
| 1295024719 | David D Russell | Rehabilitation Counselor | 4410 Dillon Ln Ste 17, Corpus Christi, TX 78415-5335 | 2011-04-05 |
| 1932321700 | David Stanton Russell | Radiology | 2113 Wilshire Dr, Enid, OK 73703-6622 | 2007-05-02 |
| 1336269109 | David Lee Russell Sr. | Dentist | 14 Racetrack Rd Nw, Fort Walton Beach, FL 32547-1642 | 2007-03-29 |
| 1528196516 | David Henry Russell | Dentist | 4414 Kukui Grove St, Suite #103, Lihue, HI 96766-2016 | 2007-03-01 |
| 1386730018 | David Robert Russell | Dentist | 8334 Winter Gardens Blvd, Lakeside, CA 92040-5409 | 2006-10-04 |
| 1376551192 | David Richard Russell | Dentist | 660 Rising Sun Road, Millersburg, PA 17061 | 2006-08-04 |
| 1184654501 | David Alfred Russell | Dentist | #3 Post Office Square, Suite #900, Boston, MA 02109 | 2006-07-03 |
| 1740233162 | David Lee Russell | Family Medicine | 7 Deye Ln, Eastsound, WA 98245-8578 | 2006-05-18 |
| 1962472555 | David Christopher Russell | Chiropractor | 2239 N Prospect Ave, Milwaukee, WI 53202-6301 | 2006-01-25 |
| Street Address |
17846 GLENWOOD RD |
| City | MANTECA |
| State | CA |
| Zip Code | 95336-9521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687676 | Kasside Sahagun-escalante | Behavior Technician | 402 Victory Ave, Manteca, CA 95336 | 2019-09-09 |
| 1295253797 | Adriana Pena | Counselor | 129 E.center Street Ste.3, Manteca, CA 95336 | 2017-09-05 |
| 1104352277 | Native Directions Inc. | Substance Abuse Rehabilitation Facility | 13505 Union Rd, Manteca, CA 95336 | 2017-05-10 |
| 1437508389 | Anna Gavin | Contractor | 1256 W. Lathrop Rd #376, Manteca, CA 95336 | 2016-06-10 |
| 1164826137 | Michael M. Catz, M.d., Inc | Anesthesiology | 1205 E. North Street, Manteca, CA 95336 | 2014-10-20 |
| 1033518923 | Leanne Louis | Community Health Worker | 129 E Center Street, #3, Manteca, CA 95336 | 2014-08-18 |
| 1255684122 | Kenneth S. Ching, Md., Inc | Anesthesiology | 1205 East North Street, Manteca, CA 95336 | 2012-10-17 |
| 1629323043 | Harpradeep Ratia | Dentist | 1332 E Yosemite Ave, Manteca, CA 95336 | 2012-07-23 |
| 1750643664 | Shelley Marie Kohl | Specialist/Technologist, Other | 425 E. Center St Suite 1, Manteca, CA 95336 | 2012-06-15 |
| 1932488038 | Valerie Diane Segura | Behavioral Analyst | 1882 Cherrywood Pl, Manteca, CA 95336 | 2011-08-08 |
| Find all providers in zip 95336 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154573 | Marcus Jang | Nurse Practitioner | 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 | 2020-11-04 |
| 1033718580 | John Sylvanus Allieu Sr. | Nurse Practitioner | 2672 Merganser Ct, Los Banos, CA 93635-9473 | 2020-10-25 |
| 1316546930 | Chika U Oguagha | Nurse Practitioner | 16240 Carmine St, Fontana, CA 92336-1481 | 2020-10-23 |
| 1215534888 | Rosa Maria Aguero | Nurse Practitioner | 9841 Alburtis Ave Unit 29, Santa Fe Springs, CA 90670-3264 | 2020-10-06 |
| 1134726995 | Margarita Maghtesyan | Nurse Practitioner | 20251 Ventura Blvd Ste A, Woodland Hills, CA 91364-2564 | 2020-10-05 |
| 1043827140 | April Lopez Ortiz | Nurse Practitioner | 500 W Ashland Ct, Visalia, CA 93277-6609 | 2020-09-23 |
| 1194339382 | Albert Liu | Nurse Practitioner | 43559 Southerland Way, Fremont, CA 94539-5931 | 2020-09-03 |
| 1407469554 | Andre Alexandrian | Nurse Practitioner | 1606 Winona Ave, Burbank, CA 91504-2823 | 2020-08-28 |
| 1790398238 | Heather Richardson | Nurse Practitioner | 112 S Park St Ste 1, San Francisco, CA 94107-1809 | 2020-08-25 |
| 1750994323 | Gina Ameri | Nurse Practitioner | 10968 Rose Ave Apt 6, Los Angeles, CA 90034-5329 | 2020-08-24 |
| Find all providers with the same taxonomy | ||||
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| 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.