Active NPI
Russell Jay Niland
- Peer Specialist
- San Diego, CA
National Provider Identifier
1639010101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-WMGELR
- Practice address
- 1011 Camino del Rio South
Suite 300
San Diego, CA 92108 - Phone
- (619) 287-8225
- Fax
- (619) 393-0386
- NPI assigned
- Apr 1, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-WMGELR | CA | Primary |
| Rehabilitation Practitioner | 225400000X | CA |
Addresses
Primary practice location
1011 Camino del Rio South
Suite 300
San Diego, CA 92108
Mailing address
1011 Camino del Rio South
Suite 300
San Diego, CA 92108
Phone (619) 287-8225
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 |
|---|---|---|---|
| MPSS-WMGELR | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775088000000",
"number": "1639010101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 CAMINO DEL RIO SOUTH",
"address_2": "SUITE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92108",
"telephone_number": "619-287-8225",
"fax_number": "619-393-0386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 CAMINO DEL RIO SOUTH",
"address_2": "SUITE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92108",
"telephone_number": "619-287-8225",
"fax_number": "619-393-0386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NILAND",
"first_name": "RUSSELL",
"middle_name": "JAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-01",
"last_updated": "2026-04-02",
"certification_date": "2026-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-WMGELR",
"primary": true
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.