Irene Russo, MS PSYCHOLOGY

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF92506 Issued in CA

Practice address

1225 Cornell Ave
Berkeley, CA 94706-2307

Phone

(510) 384-9749

NPI assigned

Feb 2, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Early Days Autism Center

  • Clinical Psychologist
  • Sacramento, CA
  • NPI 1790223675

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1831637461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CORNELL AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947062307",
            "telephone_number": "510-384-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CORNELL AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947062307",
            "telephone_number": "510-384-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "IRENE",
        "credential": "MS PSYCHOLOGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF92506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERN MARRIAGE AND FAMILY THERAPIST",
            "identifier": "IMF92506",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Lee Rush, MFT
• Astrid Norma Rusquellas, M.D.
• Amanda Jayne Russell, PSYD
• Carole Russell, N.P.
• Kevin Russell, L.AC.
• Vincent Russo, CAADAC
• Marjan Rusta, D.D.S
• Taly Rutenberg, LCSW
• Joshua Jacob Rutt
• Matthew Rutzi

• Marriage & Family Therapist in Berkeley, CA
• Providers in Berkeley, 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 Feb 2, 2017; 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.