DR. ANA RUTH REVILLA (NPI# 1083792501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083792501 |
| Entity Type | Individual |
| Full Name | DR. ANA RUTH REVILLA |
| Credential | M.D. |
| Practice Address |
701 E Channel St Stockton CA 95202-2628 |
| Mailing Address |
Po Box 779 Stockton CA 95201-0779 |
| Practice Telephone | 2099444700 |
| Practice Fax Number | 2099444727 |
| Mailing Telephone | 2093732800 |
| Mailing Fax Number | 2093732873 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A81029 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
701 E CHANNEL ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95202-2628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578552543 | Community Medical Centers, Inc | Clinic/Center | 701 E Channel St, Stockton, CA 95202-2628 | 2005-10-20 |
| 1376175265 | Lisa Gildea | Dental Hygienist | 701 E Channel St, Stockton, CA 95202-2628 | 2020-02-07 |
| 1427524156 | Katherine Francis Ketz | Nurse Practitioner | 701 E Channel St, Stockton, CA 95202-2628 | 2018-10-20 |
| 1639676422 | Olivia Millan | Lactation Consultant, Non-RN | 701 E Channel St, Stockton, CA 95202-2628 | 2018-04-09 |
| 1982101911 | Erin Kathleen Garcia | Dietitian, Registered | 701 E Channel St, Stockton, CA 95202-2628 | 2018-04-06 |
| 1871092320 | Pam Thao | Assistant Behavior Analyst | 701 E Channel St, Stockton, CA 95202-2628 | 2018-02-09 |
| 1336665587 | Elaine Sze Ho | Family Medicine | 701 E Channel St, Stockton, CA 95202-2628 | 2017-08-18 |
| 1770036642 | Pak-hei Hui | Pharmacist | 701 E Channel St, Stockton, CA 95202-2628 | 2016-07-27 |
| 1417361395 | Issa Sidibe | Nurse Practitioner | 701 E Channel St, Stockton, CA 95202-2628 | 2014-06-18 |
| 1821381179 | David Graham | Nurse Practitioner | 701 E Channel St, Stockton, CA 95202-2628 | 2011-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336774678 | Lecletus Griffin Jr. | Counselor | 1212 N. Califronia Street, Stockton, CA 95202 | 2020-03-06 |
| 1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
| 1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
| 1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1912406976 | Janet Mendoza | Social Worker | 6 South Eldorado Street, Stockton, CA 95202 | 2018-02-06 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1124545355 | Suleyma Velesquez | Counselor | 445 N. San Joaquin St., Stockton, CA 95202 | 2017-08-28 |
| 1821513946 | Savoeun Phal | Counselor | 1212 N California St Ste A214, Stockton, CA 95202 | 2017-08-09 |
| 1861921272 | Mandeep K Minhas | Registered Nurse | 1212 California St, Stockton, CA 95202 | 2017-06-08 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649496597 | Geny B. Burgos M. D. Inc. | Pediatrics | 1801 E March Ln Ste C340, Stockton, CA 95210-6629 | 2007-04-18 |
| 1164588463 | Beverly Morgan | Pediatrics | 2233 Grand Canal Blvd Ste 105, Stockton, CA 95207-8117 | 2006-12-29 |
| 1427128990 | Kamela Taheri | Pediatrics | 1721 E Hammer Ln, Stockton, CA 95210-4124 | 2006-11-09 |
| 1316025810 | Loan K. Bui-thompson | Pediatrics | 2349 N. California St., Stockton, CA 95204-5505 | 2006-11-01 |
| 1265534416 | Blesilda Palado Esteves | Pediatrics | 75 West March Lane, Ste K, Stockton, CA 95207 | 2006-09-01 |
| 1790799575 | Hilario Sabarillo Esguerra IIi | Pediatrics | 73 W March Lane Suite F, Stockton, CA 95207 | 2006-07-28 |
| 1811918931 | Stockton Pediatric Med. Group, Inc. | Pediatrics | 2349 N California St, Stockton, CA 95204-5505 | 2006-07-22 |
| 1376574616 | Susan M Abraham | Pediatrics | 1414 N California St, Stockton, CA 95202-1515 | 2006-07-05 |
| 1154359172 | Bryant Bennett Williams Jr. | Pediatrics | 1339 S Madison St, Stockton, CA 95206-1751 | 2006-06-29 |
| 1851328991 | Charles Robert Mccormick | Pediatrics | 1240 W Robinhood Dr, Suite G, Stockton, CA 95207-5507 | 2006-06-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.