Active NPI
Ryan Russ
- Counselor
- Canoga Park, CA
National Provider Identifier
1053276865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 22122 Sherman Way
Canoga Park, CA 91303-1140 - Phone
- (323) 356-4848
- NPI assigned
- Dec 23, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
22122 Sherman Way
Canoga Park, CA 91303-1140
Mailing address
615 Ocean Ave Apt J
Santa Monica, CA 90402-2643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766448000000",
"number": "1053276865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 OCEAN AVE APT J",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904022643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22122 SHERMAN WAY",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913031140",
"telephone_number": "323-356-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSS",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-12-23",
"last_updated": "2025-12-23",
"certification_date": "2025-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.