REVITAL AHL (NPI# 1538769062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538769062 |
| Entity Type | Individual |
| Full Name | REVITAL AHL |
| Practice Address |
18141 Medley Dr Encino CA 91316-4447 |
| Practice Telephone | 8184224077 |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 58759 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
18141 MEDLEY DR |
| City | ENCINO |
| State | CA |
| Zip Code | 91316-4447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883341 | Kerry Ann Mclean | Marriage & Family Therapist | 1777 Ventura Blvd Unit 103, Encino, CA 91316 | 2020-05-27 |
| 1336793124 | Achieve Speech Associates, Inc. | Clinic/Center | 17605 Ventura Boulevard, #302, Encino, CA 91316 | 2019-07-30 |
| 1053978312 | Somnia Sleep Science & Treatment Center | Clinic/Center | 5435 Balboa Blvd Suite 100, Encino, CA 91316 | 2019-05-22 |
| 1437634466 | New Spirit Recovery, LLC | Substance Abuse Rehabilitation Facility | 17856 Cathedral Pl., Encino, CA 91316 | 2018-09-25 |
| 1649762014 | Hashemi Ophthalmology, PC | Ophthalmology | 5353 Balboa Blvd Ste 110, Encino, CA 91316 | 2018-06-01 |
| 1932614310 | Hannah Esther Weinsrein | Marriage & Family Therapist | 17337 Ventura Blvd., Sutie #317, Encino, CA 91316 | 2017-12-07 |
| 1881118560 | Paula Miley | Marriage & Family Therapist | 5535 Balboa Blvd #202, Encino, CA 91316 | 2017-08-03 |
| 1477088193 | Rachela Conti | Psychologist | 5400 Balboa Blvd. #311, Encino, CA 91316 | 2017-05-01 |
| 1962857235 | Jessica Shlager | Occupational Therapist | 6345 Balboa Boulevard Suite 120, Encino, CA 91316 | 2016-04-25 |
| 1720432800 | Canyon West Los Angeles LLC | Clinic/Center | 17167 W. Ventura Boulevard, Encino, CA 91316 | 2016-04-14 |
| Find all providers in zip 91316 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770142937 | Erika Carreon | Physician Assistant | 5353 Balboa Blvd Ste 104, Encino, CA 91316-2858 | 2019-06-11 |
| 1255880720 | Niloofar Khandadash | Physician Assistant | 5130 Yarmouth Ave, Apt 27, Encino, CA 91316-3303 | 2016-09-26 |
| 1013249275 | Melissa Sue Brown | Physician Assistant | 15503 Ventura Blvd, Suite 370, Encino, CA 91436-3140 | 2010-02-12 |
| 1659902575 | Meghan Pyle | Physician Assistant | 16311 Ventura Blvd Ste 1150, Encino, CA 91436-4386 | 2020-01-29 |
| 1922645993 | Michelle Roya Eshaghian | Physician Assistant | 16133 Ventura Blvd Ste 340, Encino, CA 91436-2428 | 2019-12-09 |
| 1083040943 | Courtney Morgan Campbell | Physician Assistant | 16030 Ventura Blvd, Suite 100, Encino, CA 91436-2731 | 2013-09-23 |
| 1053666974 | Sipora Zarbakhsh | Physician Assistant | 16952 Ventura Blvd Ste 100, Encino, CA 91316-4193 | 2012-07-17 |
| 1891022448 | Kerry Ann Schlosser | Physician Assistant | 16500 Ventura Blvd, Ste. 409, Encino, CA 91436-2011 | 2009-11-03 |
| 1720198385 | David Gilles Dufour | Physician Assistant | 16101 Ventura Blvd, Suite 340, Encino, CA 91436-2500 | 2006-08-30 |
| 1639129729 | Monte Carl Burnam | Physician Assistant | 16260 Ventura Blvd, 140, Encino, CA 91436-2203 | 2006-05-11 |
| Find all providers in ENCINO | ||||
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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.