DR. SCOT W. RUSSELL (NPI# 1407858988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407858988 |
| Entity Type | Individual |
| Full Name | DR. SCOT W. RUSSELL |
| Credential | PH.D. |
| Practice Address |
1200 El Camino Real South San Francisco CA 94080 |
| Practice Telephone | 6507423841 |
| Practice Fax Number | 6507422591 |
| Mailing Telephone | 6507423841 |
| Mailing Fax Number | 6507422591 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2009-05-12 |
| NPI Deactivation Date | 03/22/2006 |
| NPI Reactivation Date | 2006-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PSY 22480 | CA | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
1140332501 | UT | Behavioral Health & Social Service Providers |
| Street Address |
1200 EL CAMINO REAL |
| City | SOUTH SAN FRANCISCO |
| State | CA |
| Zip Code | 94080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131351 | Guerline Bornelus | Registered Nurse | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2020-10-12 |
| 1174134258 | Trista Yuen Ting Tam | Pharmacist | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2020-08-12 |
| 1831707686 | Kurt Herman Theumer | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2020-07-17 |
| 1538787346 | Maryfloriel Lozada | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2020-07-08 |
| 1881235109 | Sau Ming Lam | Dietitian, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2019-10-08 |
| 1073078606 | Vue Ngoy | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2019-02-07 |
| 1891269510 | Zachary Robert Cinti | Physician Assistant | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2019-01-15 |
| 1770056756 | Debora M Creighton-vaz | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2019-01-02 |
| 1508338088 | Melissa Anne Dayao | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2018-12-21 |
| 1891267696 | Jennifer Rebollido | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2018-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245704303 | Patricia Sweeney | Nurse Practitioner | 435 Gran Ave, South San Francisco, CA 94080 | 2019-01-11 |
| 1518446988 | Yessenia Patricia Pena Ruiz | Counselor | 117 Pecks Ln, South San Francisco, CA 94080 | 2018-08-07 |
| 1982112579 | Breanna Mottau | Behavioral Analyst | 751a Camino Plaza, San Bruno, CA 94080 | 2018-01-17 |
| 1720594294 | Patricia Lynn Jasper | Nurse Practitioner | 395 Oyster Point Blvd., Suite 128, South San Francisco, CA 94080 | 2017-12-20 |
| 1184146755 | Breanne Ho | Student in an Organized Health Care Education/Training Program | 130 Nursery Way, South San Francisco, CA 94080 | 2017-07-14 |
| 1568843787 | Lita Wu | Optometrist | 119 Hickey Blvd, South San Francisco, CA 94080 | 2015-06-12 |
| 1720479553 | Naf Nasser Almadari | Physician Assistant | 717 Baden Ave, San Francisco, CA 94080 | 2015-02-16 |
| 1528459351 | Alexander M Gold | Internal Medicine | 270 East Grand Avenue, South San Francisco, CA 94080 | 2015-02-16 |
| 1548673411 | Elite Care Home Health Agency, Inc. | Home Health | 91 Westborough Blvd Ste 2020, South San Francisco, CA 94080 | 2014-06-08 |
| 1720415979 | Optometry Eyecareeyewear Com Inc | Optometrist | 601 Gateway Blvd., Suite 220, South San Francisco, CA 94080 | 2013-10-02 |
| Find all providers in zip 94080 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746650 | Alexandria Marie Schick | Psychologist | 2785 Cold Springs Rd Apt 31, Placerville, CA 95667-3240 | 2020-10-08 |
| 1841804853 | Nia Mayers Franklin | Psychologist | 8940 S Hobart Blvd, Los Angeles, CA 90047-3615 | 2020-09-08 |
| 1871104307 | Erania Marie Martin-lang | Psychologist | 13329 Arbor Park Ln, Moreno Valley, CA 92553-6916 | 2020-08-10 |
| 1366051070 | Shellie Renae Higuera | Psychologist | 5059 Day Dr, Fairfield, CA 94533-6597 | 2020-07-28 |
| 1730706979 | Oak Forest Recovery Center, Inc. | Psychologist | 5655 Lindero Canyon Rd Ste 425, Westlake Village, CA 91362-4046 | 2020-07-04 |
| 1861016842 | Valley Harvest Church of Merced | Psychologist | 557 W 26th St, Merced, CA 95340-2825 | 2020-06-04 |
| 1629691993 | Franklin Clifford Wimberly | Psychologist | 10 Pleasant Walk, Aliso Viejo, CA 92656-4266 | 2020-05-21 |
| 1790325694 | Pacific Forensic Psychology Associates, Inc | Psychologist | 19230 Sonoma Highway, Building 200, Sonoma, CA 95476 | 2020-01-09 |
| 1386282762 | Danielle Wischenka | Psychologist | 155 E Campbell Ave Ste 219, Campbell, CA 95008-2062 | 2019-12-16 |
| 1528525326 | Sylvia Cary | Psychologist | 4650 Sepulveda Blvd Apt 201, Sherman Oaks, CA 91403-2462 | 2019-02-28 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH SAN FRANCISCO |
| Zip Code | 94080 |
Please comment or provide details below to improve the information on DR. SCOT W. 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.