DR. SCOT W. RUSSELL PH.D. NPI 1407858988

NPI Information

NPI: 1407858988
Provider Name: DR. SCOT W. RUSSELL, PH.D.
Classification: Psychologist - 103TB0200X
Entity Type: Individual

Specialization: Cognitive & Behavioral

PECOS Registration: Yes

Address:
1200 EL CAMINO REAL
SOUTH SAN FRANCISCO, CA
ZIP 94080
Phone: (650) 742-3841
Get Directions

DR. Scot W. Russell, PH.D. is a cognitive and behavioral psychologist in South San Francisco, CA. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. DR. Scot W. Russell, PH.D. NPI is 1407858988. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1200 EL CAMINO REAL
SOUTH SAN FRANCISCO, CA
ZIP 94080
Phone: (650) 742-3841
Fax: (650) 742-2591

The NPI 1407858988 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 8/15/2005 and was last updated on 5/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TB0200X	Psychologist	Cognitive & Behavioral	1140332501	UTAH	No
2	103TB0200X	Psychologist	Cognitive & Behavioral	PSY 22480	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	R56071	MEDICARE UPIN	UTAH
2	000012077	MEDICARE ID-TYPE UNSPECIFIED	UTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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