Active NPI
Angela Russell
- Clinical Social Worker
- Los Alamitos, CA
National Provider Identifier
1447688874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 121106
- Practice address
- 4225 Green Ave
Los Alamitos, CA 90720-3569 - Phone
- (562) 230-3044
- NPI assigned
- Oct 22, 2013
- Last updated
- May 9, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 121106 | CA | Primary |
Addresses
Primary practice location
4225 Green Ave
Los Alamitos, CA 90720-3569
Mailing address
1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (310) 221-6336
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 |
|---|---|---|---|
| 121106 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1447688874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 HUGHES WAY STE 150",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908101878",
"telephone_number": "310-221-6336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 GREEN AVE",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907203569",
"telephone_number": "562-230-3044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "ANGELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-22",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "121106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.