Nicole Lorraine Russo, ASW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

ASW103130 Issued in CA

Practice address

2115 The Alameda
San Jose, CA 95126-1141

Phone

(669) 213-0673

Fax

(408) 259-2273

NPI assigned

Aug 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1326528522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E ANGELA ST",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667413",
            "telephone_number": "925-786-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261141",
            "telephone_number": "669-213-0673",
            "fax_number": "408-259-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "NICOLE",
        "middle_name": "LORRAINE",
        "name_prefix": "Miss",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2021-10-05",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW103130",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsey Russell
• Harriet Russell, DPT
• Henry James Russell
• Isaiah Franklyn Eugene Russell
• Therese Marie Russi-Schou I, PH.D.
• Edward Rustamzadeh, M.D.
• Edward J Rutledge, DDS
• Emma Rutter
• Peter J Rutti, MD
• Sandra Ruvalcaba Diaz

• Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.