Jenifer Lynn Russell, RADT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1733 Euclid Ave
San Diego, CA 92105-5414

Phone

(619) 263-0433

Fax

(614) 926-3399

NPI assigned

Jul 9, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vietnam Veterans of San Diego

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1396873451
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1124865944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 SAMS HILL RD APT 13",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920213075",
            "telephone_number": "858-717-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 EUCLID AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055414",
            "telephone_number": "619-263-0433",
            "fax_number": "614-926-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JENIFER",
        "middle_name": "LYNN",
        "credential": "RADT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Russell, SLP
• Chantal Russell, D.C., L.AC.
• Claire Russell
• Ian Russell, DO
• Ian Jeffrey Russell
• Kathryn Russell
• Kevin L. Russell, MD, MTM&H
• Kim Koehler Russell, OTR/L
• Laura Russell, LCSW
• Marie Russell, RN, MN, C-ANP

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.

Verify at the official NPI Registry.