Peggy L Russell

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C6191214 Issued in CA

Practice address

3707 E Shields Ave
Fresno, CA 93726-7029

Phone

(559) 229-9040

Fax

(559) 229-9060

NPI assigned

Aug 15, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1770739229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 E SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937267029",
            "telephone_number": "559-229-9040",
            "fax_number": "559-229-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937267029",
            "telephone_number": "559-229-9040",
            "fax_number": "559-229-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "PEGGY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C6191214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAPP",
            "identifier": "C6191214",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Russell, PHARM.D.
• Karen M Russell, PPS
• Maureen Russell, LCSW
• Michael Joseph Russell
• Michele C Russell, PH.D.
• Roslynn Pertrise Russell, PT 34682
• Steven James Russell
• Amy L Russo, AMFT
• Chad Russo, PHAMD
• James Russo

• Addiction (Substance Use Disorder) Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.