Theresa Russell

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

157606 Issued in CA

Practice address

13223 Black Mountain Rd
Ste 1 #1037
San Diego, CA 92129

Phone

(240) 688-9035

NPI assigned

Jan 29, 2026

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1769644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1275483422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13223 BLACK MOUNTAIN RD",
            "address_2": "STE 1 #1037",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13223 BLACK MOUNTAIN RD",
            "address_2": "STE 1 #1037",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92129",
            "telephone_number": "240-688-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "157606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ondrea Necole Russell
• Rebecca Jean Russell, LMFT
• Sabrina Kristina Russell
• Samuel Peter Russell, MD
• Teresa M Russell, NP
• Sean Russick, PA-C
• Andrea Russo, OD
• Candace Rae Russo, PHARMD
• Hana Marie Russo, MD
• Ivana Russo, RN

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.