Sandra Geraldine Russo, RD

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

838417 Issued in CA

Practice address

2925 Palo Verde Ave
Long Beach, CA 90815-1552

Phone

(562) 429-2473

Fax

(562) 496-5577

NPI assigned

Jun 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Talbert Medical Group, P.C.

  dba Talbert Medical Group

  • Internal Medicine Physician
  • Fountain Valley, CA
  • NPI 1528069176
  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1467657767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151552",
            "telephone_number": "562-429-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 PALO VERDE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151552",
            "telephone_number": "562-429-2473",
            "fax_number": "562-496-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "SANDRA",
        "middle_name": "GERALDINE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "CA",
            "license": "838417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDR",
            "identifier": "8381417",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Russell II
• Trevor William Russell
• Tylore Russell
• Audrey Russo, R.N.
• Leonard Ross Russo, DDS
• Richard P. Rutgers, M.D.
• Anne Rutkowski, MS, AMFT, APCC
• Anne M Rutkowski, MD
• Marisah Rutledge
• Jasmin Ruvalcaba

• Metabolic Nutrition Registered Dietitian in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Metabolic Nutrition Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.