Core Revive / Soul Revive LLC
Core Revive / Soul Revive LLC is a Diabetes Educator Registered Nurse in Petaluma, California. Licensed in California. Registered with an NPI since 2018.
- Licensed in
- CA
- In the registry since
- 2018
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
16 Queens LnPetaluma, CA 94952-1047
Phone: (707) 559-5347
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nutrition Support Registered Nurse (primary) | Taxonomy 163WN1003X · Licence 846331 (CA) |
|---|---|
| Diabetes Educator Registered Nurse | Taxonomy 163WD0400X · Licence 846331 (CA) |
Record details
| NPI number | 1154826980 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Philip Diehl — Partner · (415) 250-7118 |
| Other names | Core Revive |
| NPI enumerated | March 26, 2018 |
| Last updated in NPPES | June 11, 2019 |
| Mailing address | 16 Queens Ln, Petaluma, CA 94952-1047 |