Matthew B Russell

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT122031 Issued in CA

Practice address

4125 Temescal St Ste G
Fair Oaks, CA 95628-7558

Phone

(916) 619-7744

NPI assigned

Oct 27, 2020

Sex

Male

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

State licenses

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1386244648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 TEMESCAL ST STE G",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287558",
            "telephone_number": "916-619-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 TEMESCAL ST STE G",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287558",
            "telephone_number": "916-619-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT122031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariza Romero
• Timothy Bennett Rood, LMFT
• Kristel Roper, LMFT, LPCC
• Shirley Jean Rouge, LMFT
• Yamilethl Ruiz Flores
• Sandra Russell, MFT
• Ryan Wittwer DDS & Joseph Rawlins DDS
• Nancy L Ryan, LMFT
• Sacramento Autism Services
• Sacramento Dermatology Med Group Inc

• Marriage & Family Therapist in Fair Oaks, CA
• Providers in Fair Oaks, 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 Oct 27, 2020; 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.