David Russell, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95039943 Issued in CA

Practice address

4545 Georgetown PL Ste D
Stockton, CA 95207-6229

Phone

(209) 554-5581

NPI assigned

Sep 3, 2020

Last updated

Apr 21, 2026By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

53.98 of 100Reported as group

Quality

11.8

Promoting interoperability

74

Improvement activities

0

Cost

82.7

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.russell.p1@direct.tpcp.nextgenshare.com

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.

• San Joaquin Behavioral Health Services

  dba San Joaquin County Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Enhance Psychiatric Advanced Nursing Services Inc

  • Adult Mental Health Clinic/Center
  • Manteca, CA
  • NPI 1437826286
  NPD Authorized official
• County of San Joaquin

  dba San Joaquin County Clinic Manteca

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• San Joaquin County Behavioral Health Services

  dba Community Adult Treatment Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stockton, CA
  • NPI 1043426869
  NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1477167666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 GEORGETOWN PL STE D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076229",
            "telephone_number": "209-554-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 GEORGETOWN PL STE D",
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            "postal_code": "952076229",
            "telephone_number": "209-554-5581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3455 American River Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958645751",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Clay St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946121425",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "793 Higuera St Ste 5",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934013571",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7250 Redwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Novato",
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            "postal_code": "949453268",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "437 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Red Bluff",
            "state": "CA",
            "postal_code": "960802709",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Garden Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939405392",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E 13th St",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953416211",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2555 Flores St",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944032342",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 W Figueroa St",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931013189",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 Willow Pass Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945205292",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2999 Douglas Blvd",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956613840",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 S Flower St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900174101",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Barranca Pkwy",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926065018",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4713 Greenleaf Ct",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953569774",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2940 Summit St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093416",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3880 S Bascom Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951242674",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4545 Georgetown Pl Ste D",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952076229",
            "country_code": "US",
            "telephone_number": "209-554-5581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 N Market St",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951131112",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17846 Glenwood Rd",
            "address_purpose": "LOCATION",
            "city": "Manteca",
            "state": "CA",
            "postal_code": "953369521",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Soquel Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950622305",
            "country_code": "US",
            "telephone_number": "866-931-2587",
            "fax_number": "866-380-0676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DAVID",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-03",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95039943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abishai Tichaona Rumano, MD
• Krista Runnings, DPT
• Rikhart Dok Rupnik, DOCTOR PUBLIC HEALTH
• Kelli Marie Rushine
• Raina Russell-Shaffer, MSN, FNP-C
• David Julius Russell, D.O.
• Guy R. Russell
• Jason L Russell
• Sasha Russell
• Christopher Adamo Russo, DO, MPH

• Psychiatric/Mental Health Nurse Practitioner in Stockton, CA
• Providers in Stockton, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.