Organization · Type 2 NPI

Revive Salon and Spa

Family Nurse Practitioner · San Diego, CA

NPI number 1619415072 Active

Practice location

5965 Village Way, E207
San Diego, CA 92130-2475

Call (619) 293-7233 Map

Mailing address

4328 Mount Hukee Ave
San Diego, CA 92117-4738

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95005931 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1619415072

Revive Salon and Spa's National Provider Identifier is 1619415072, issued on Feb 6, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Diego, CA. The record was last updated on Feb 6, 2017.