Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Theresa Russell

Individual provider Marriage & Family Therapist · NPI 1275483422

Theresa Russell is a Marriage and Family Therapist in San Diego, California. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2026
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Practice location Address checks out

13223 Black Mountain Rd Ste 1 #1037
San Diego, CA 92129
Phone: (240) 688-9035
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 157606 (CA)

Record details

NPI number1275483422
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 29, 2026
Last updated in NPPESJanuary 29, 2026
Certification dateJanuary 28, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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