Individual provider · Type 1 NPI

Russell Jay Niland

Peer Specialist · San Diego, CA

NPI number 1639010101 Active

Practice location

1011 Camino Del Rio South, Suite 300
San Diego, CA 92108

Call (619) 287-8225 Map

Fax (619) 393-0386

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XMPSS-WMGELR (CA)
Rehabilitation Practitioner 225400000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1639010101

Russell Jay Niland's National Provider Identifier is 1639010101, issued on Apr 1, 2026. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in San Diego, CA. The record was last updated on Apr 2, 2026.