Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revitalized Family Care

Organization Family Nurse Practitioner · NPI 1508488750

Revitalized Family Care is a Family Nurse Practitioner in Sonora, California. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

673 Pauline Ct
Sonora, CA 95370-5216
Phone: (209) 404-6746
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1508488750
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dayna Iverson — President · (209) 404-6746
NPI enumeratedMay 11, 2020
Last updated in NPPESMay 11, 2020
Certification dateMay 11, 2020
Mailing address4906 Webster Rd, Oakdale, CA 95361-7850

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