Peter Christian Russell, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

16749 Issued in CA

Practice address

9500 Gilman Dr # Mc0304
Ucsd Counseling & Psychological SRVS
La Jolla, CA 92093-5004

Phone

(858) 534-3755

Fax

(858) 534-2628

NPI assigned

May 19, 2008

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1770740631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR # MC0304",
            "address_2": "UCSD COUNSELING & PSYCHOLOGICAL SRVS",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920935004",
            "telephone_number": "858-534-3755",
            "fax_number": "858-534-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR # MC0304",
            "address_2": "UCSD COUNSELING & PSYCHOLOGICAL SRVS",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920935004",
            "telephone_number": "858-534-3755",
            "fax_number": "858-534-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "PETER",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "16749",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "16749",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rumsey, APRN, FNP-BC, DNP
• Julie Rumsey
• Garrett Rupp
• John State Rusin, PT, DPT, CSCS
• Jacob Russell, DDS
• Francesco Gino Russo, PHARM D
• Robert J. Russo, M.D. PHD
• Samantha Glory Russo, PHARMD
• Tracy Lee Ruymann, MD
• Andrew Joseph Ryan, PHARM.D.

• Psychologist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.