Matthew Russell, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

31637 Issued in CA

Practice address

520 S Grand Ave Ste 671
Los Angeles, CA 90071-2655

Phone

(323) 446-2820

NPI assigned

Oct 6, 2015

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Russell Psychological Corp.

  • Psychologist
  • Los Angeles, CA
  • NPI 1851916852
  NPD Authorized official

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1821468604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S GRAND AVE STE 671",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900712655",
            "telephone_number": "323-446-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S GRAND AVE STE 671",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900712655",
            "telephone_number": "323-446-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94022429",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "31637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jannell Chakakhan Russell
• Jennifer Russell, A-G NP
• Kimberly J Russell, P.T.
• Marcia McGory Russell, MD
• Marie Russell
• Michael Cody Russell
• Michael Hughes Russell, MD
• Patricia L Russell, LCSW
• Rachel J Russell
• Rochelle R Russell, LCSW

• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.