Jacquelyn Carole Russum, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

600544 Issued in CA

Practice address

3600 Telegraph Ave
Oakland, CA 94609-2427

Phone

(510) 383-5161

NPI assigned

Aug 20, 2025

Last updated

Aug 20, 2025By the provider in NPPES

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 names 1

• Jacquelyn Carole Russum Professional name

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": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1710864657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 1ST ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013716",
            "telephone_number": "510-710-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092427",
            "telephone_number": "510-383-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSUM",
        "first_name": "JACQUELYN",
        "middle_name": "CAROLE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "600544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "RUSSUM",
            "middle_name": "CAROLE",
            "credential": "RDN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leezae Russell
• Natalie Eleni Russell
• Rose Delaine Russell, DC
• Talaisa Russell
• Jennifer Russo, MS, LEP
• David Rustamzadeh, DDS, MSD
• Emerson Brock Rustand, MD
• Joanna Carr Ruthenberg, M.D.
• Chelsea Rutherford
• Jasmine J Rutherford

• Registered Dietitian in Oakland, CA
• Providers in Oakland, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.