Individual provider · Type 1 NPI

Paul Robert Russo, FNP

Nurse Practitioner · San Diego, CA

NPI number 1164465753 Active

Practice location

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Call (619) 532-8109 Map

Mailing address

PO Box 130192
Carlsbad, CA 92013-0192

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X1112141 (TX)
Nurse Practitioner 363L00000XNP10524 (CA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1164465753

Paul Robert Russo, FNP's National Provider Identifier is 1164465753, issued on Jun 13, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in San Diego, CA. The record was last updated on Feb 23, 2026.