DR. PETER ROBERT RUSSELL (NPI# 1174540645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174540645 |
| Entity Type | Individual |
| Full Name | DR. PETER ROBERT RUSSELL |
| Credential | PH D |
| Practice Address |
10420 El Camino Real Atascadero CA 93422-6882 |
| Practice Telephone | 8054665641 |
| Practice Fax Number | 8054662989 |
| Mailing Telephone | 8054665641 |
| Mailing Fax Number | 8054662989 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | PSY 5273 | CA | Behavioral Health & Social Service Providers |
| X | 103T00000X | Psychologist | PSY 5273 | CA | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
PSY 5273 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | QME | 002356 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770740631 | Peter Christian Russell | Psychologist | 9500 Gilman Dr # Mc0304, Ucsd Counseling & Psychological Srvs, La Jolla, CA 92093-5004 | 2008-05-19 |
| 1346386489 | Peter Ward Russell | Licensed Practical Nurse | 12 Petra Lane, Albany, NY 12205 | 2007-01-29 |
| 1972555415 | Peter L. Russell | Family Medicine | 830 Prairie Center Dr, Eden Prairie, MN 55344-7301 | 2006-05-16 |
| Street Address |
10420 EL CAMINO REAL |
| City | ATASCADERO |
| State | CA |
| Zip Code | 93422-6882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043435977 | Joan Sandberg | Psychologist | 10420 El Camino Real, Suite 4, Atascadero, CA 93422-6882 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356903645 | Michael E Nevin | Licensed Psychiatric Technician | 6550 Morro Rd, Unit D, Atascadero, CA 93422 | 2019-07-08 |
| 1225495583 | Kelly Michelle Morrow | Counselor | 7130 Sombrilla Ave., Atascadero, CA 93422 | 2016-01-18 |
| 1609242817 | Cheyenne M Britton | Counselor | 9366 Ribereng Circle, Atascadero, CA 93422 | 2015-08-12 |
| 1033590856 | Debra Marie Califia | Counselor | 6500 Morro Rd., Aegis Treatment Centers, Atascadero, CA 93422 | 2015-06-17 |
| 1134548498 | Allison Muller | Counselor | 8000 Santa Rosa Road, Atascadero, CA 93422 | 2014-04-15 |
| 1376973875 | Jana Slezakova | Psychologist | 10333 El Camino Real Dept Of, Atascadero, CA 93422 | 2013-11-19 |
| 1013341189 | Kimberly L Schwab | Counselor | 5575 Hospital Dr., Atascadero, CA 93422 | 2013-08-26 |
| 1982941274 | Krisitana Lynn Hatcher Miller | Counselor | 6312 Atascadero Ave, Atascadero, CA 93422 | 2013-01-07 |
| 1588939995 | Else Mai Thi Curry | Counselor | 4000 Santa Cruz Rd, Atascadero, CA 93422 | 2012-03-19 |
| 1083987523 | Kathryn Gaoiran Bartlett | Pharmacist | 8200 El Camino Real, Atascadero, CA 93422 | 2012-02-14 |
| Find all providers in zip 93422 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497791743 | Karen Sue Sheppard | Clinical Neuropsychologist | 10333 El Camino Real, Atascadero, CA 93423-7001 | 2006-06-22 |
| 1275585002 | Leslie Joe Bolin | Clinical Neuropsychologist | 10333 El Camino Real, Atascadero, CA 93422 | 2006-05-17 |
| 1407808280 | Charles P Broderick | Clinical Neuropsychologist | 10333 El Camino Real, Atascadero, CA 93423-7001 | 2006-05-17 |
| 1578515730 | Christine Marie Mathiesen | Clinical Neuropsychologist | 10333 El Camino Real, Atascadero, CA 93423-7001 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455108 | Chelsea Vilinskas | Clinical Neuropsychologist | 2624 Larkey Ln, Walnut Creek, CA 94597-2439 | 2020-10-22 |
| 1417554049 | Andrea Alioto | Clinical Neuropsychologist | 247 San Carlos Ave, Redwood City, CA 94061-3518 | 2020-10-06 |
| 1265045975 | Well Psychology, Inc. | Clinical Neuropsychologist | 3525 Del Mar Heights Rd # 1881, San Diego, CA 92130-2199 | 2020-08-24 |
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1437767399 | Ni Sun-suslow | Clinical Neuropsychologist | 220 Dickinson St # B, San Diego, CA 92103-2071 | 2020-07-16 |
| 1366061707 | Talia Rose Seider | Clinical Neuropsychologist | 760 Westwood Plz Ste 37-360b, Los Angeles, CA 90024-5055 | 2020-04-15 |
| 1699394270 | Colin Jarred Gallagher | Clinical Neuropsychologist | 760 Westwood Plz # C8-854, Los Angeles, CA 90095-8353 | 2020-04-13 |
| 1649807058 | Nicholas S. Thaler Phd A Psychological Corporation | Clinical Neuropsychologist | 1526 14th St Ste 109, Santa Monica, CA 90404-3320 | 2020-03-25 |
| 1447890116 | Hussah Alkharafi | Clinical Neuropsychologist | 2720 Neilson Way # 5701, Santa Monica, CA 90405-4060 | 2020-01-10 |
| 1609414788 | Linda Rice | Clinical Neuropsychologist | 617 Bluegrass St, Simi Valley, CA 93065-5460 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
| City | ATASCADERO |
| Zip Code | 93422 |
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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.