THERESA RUSSELL
NPI 1275483422
Marriage & Family Therapist in San Diego, CA
About Theresa Russell NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THERESA RUSSELL (NPI 1275483422) is an individual marriage & family therapist in San Diego, California, licensed in California (157606) and active in the NPI registry since January 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Theresa Russell is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92129
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Theresa Russell's NPI number?
The NPI number for Theresa Russell is 1275483422. It was assigned to this individual provider in the NPPES registry on January 29, 2026.
Where is Theresa Russell located?
Theresa Russell practices at 13223 Black Mountain Rd Ste 1 #1037, San Diego, CA 92129. The listed phone number is (240) 688-9035.
What is Theresa Russell's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Theresa Russell enrolled in Medicare?
Yes. Theresa Russell is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Theresa Russell was last updated on January 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Theresa Russell · NPI 1275483422
Marriage & Family Therapist provider in San Diego, California. Individual provider, active in the CMS NPPES registry since January 29, 2026.
## Identity
- **NPI:** 1275483422 (Entity type: Individual)
- **Enumerated:** January 29, 2026
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 157606 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 13223 BLACK MOUNTAIN RD, STE 1 #1037, San Diego, CA 92129
- **Phone:** (240) 688-9035
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** January 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1275483422) · Data from the CMS NPPES public registry.