Michele C Russell, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY20822 Issued in CA

Practice address

3313 N Hilliard St
Fresno, CA 93726-5854

Phone

(559) 227-4810

Fax

(559) 227-4167

NPI assigned

Jul 19, 2006

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

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.

• UCSF Fresno Medical Group

  • Clinical Neuropsychologist
  • Fresno, CA
  • NPI 1487839932
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1881614519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "AHWAHNEE",
            "state": "CA",
            "postal_code": "936010357",
            "telephone_number": "559-908-1516",
            "fax_number": "559-642-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 N HILLIARD ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265854",
            "telephone_number": "559-227-4810",
            "fax_number": "559-227-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHELE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY20822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "OPL208220",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "PSY208220",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE NUMBER",
            "identifier": "PSY20822",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• Clinical Neuropsychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.