Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gina Marie Russo, SUDCCIII-CS

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1366658841

Gina Marie Russo, SUDCCIII-CS is an Addiction (Substance Use Disorder) Counselor in Fullerton, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2007
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Practice location Address checks out

218 E Commonwealth Ave
Fullerton, CA 92832-1911
Phone: (714) 992-4770
Fax: (714) 992-5745
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 8109 (CA)

Record details

NPI number1366658841
Entity typeIndividual (Type 1)
GenderFemale
Credentials SUDCCIII-CS
Sole proprietorYes
NPI enumeratedMay 14, 2007
Last updated in NPPESOctober 15, 2020
Certification dateOctober 15, 2020

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