Russell Philip Tardif, M.A., M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MX23228 Issued in CA

Practice address

18700 Beach Blvd
Suite 230
Huntington Beach, CA 92648-2030

Phone

(714) 965-9200

Fax

(714) 965-9207

NPI assigned

Aug 31, 2006

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1396856993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 BEACH BLVD",
            "address_2": "SUITE 230",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482030",
            "telephone_number": "714-965-9200",
            "fax_number": "714-965-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 BEACH BLVD",
            "address_2": "SUITE 230",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482030",
            "telephone_number": "714-965-9200",
            "fax_number": "714-965-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARDIF",
        "first_name": "RUSSELL",
        "middle_name": "PHILIP",
        "name_prefix": "Mr.",
        "credential": "M.A., M.F.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MX23228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Huntington Beach, CA
• Providers in Huntington Beach, 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 Sep 6, 2023; 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.