Russell E Gordon, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC51798 Issued in CA

Practice address

569 Higuera St
Suite D
San Luis Obispo, CA 93401-3861

Phone

(805) 704-2199

NPI assigned

Sep 22, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1710389770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 HIGUERA ST",
            "address_2": "SUITE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013861",
            "telephone_number": "805-704-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 HIGUERA ST",
            "address_2": "SUITE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013861",
            "telephone_number": "805-704-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RUSSELL",
        "middle_name": "E",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC51798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Goodwin, SOCIAL WORKER
• Brad Landon Goolsby, PA-C
• Ashlynn Nicole Gordon, D.O.
• Daniel Mark Gordon, M.D.
• Emily A Gordon, NP
• Jesse Gortarez
• Suzanne Grace Gorter, M.F.T.
• Klaus T Gottlieb, MD
• Erin Ann Gowdy
• Starlene M Graber, PHD, LMFT

• Marriage & Family Therapist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.