Deann P. Russon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60515 Issued in CA

Practice address

265 San Jacinto River Rd Ste 107
Lake Elsinore, CA 92530-4400

Phone

(951) 674-9243

NPI assigned

Nov 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Sage Counseling Services

  • Clinical Social Worker
  • Temecula, CA
  • NPI 1114640158
  NPD Authorized official

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1528248796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 SAN JACINTO RIVER RD STE 107",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304400",
            "telephone_number": "951-674-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 SAN JACINTO RIVER RD STE 107",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304400",
            "telephone_number": "951-674-9243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27710 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925904604",
            "country_code": "US",
            "telephone_number": "760-475-3425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSON",
        "first_name": "DEANN",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW60515",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "60515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Arturo Rubio
• Jennifer Marie Ruckoldt
• Darius D Ruff, BEHAVIORAL TECH
• Leticia Ruiz
• Loann Nguyen Rull
• Cassidy Ryan
• S.P.Levi,DDS, Inc.
• Farid Saadat, MD
• Robert Saavedra
• Hamid Sabet, D.C

• Clinical Social Worker in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.