Active NPI
William Russell, MFT
- Marriage & Family Therapist
- Orange, CA
National Provider Identifier
1144428756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC29703
- Practice address
- 4201 W Chapman Ave
Orange, CA 92868-1505 - Phone
- (714) 748-6210
- NPI assigned
- Jul 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC29703 | CA | Primary |
Addresses
Primary practice location
4201 W Chapman Ave
Orange, CA 92868-1505
Mailing address
101 Trafalgar LN
San Clemente, CA 92672-4265
Phone (949) 492-2698
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC29703 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144428756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 TRAFALGAR LN",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926724265",
"telephone_number": "949-492-2698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 W CHAPMAN AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928681505",
"telephone_number": "714-748-6210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "WILLIAM",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC29703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.