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

Revive Salon and Spa

Organization Family Nurse Practitioner · NPI 1619415072

Revive Salon and Spa is a Family Nurse Practitioner in San Diego, California. Licensed in California. Registered with an NPI since 2017.

Licensed in
CA
In the registry since
2017

Practice location Address checks out

5965 Village Way E207
San Diego, CA 92130-2475
Phone: (619) 293-7233
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95005931 (CA)

Record details

NPI number1619415072
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Lynn Eichert — Nurse Practitioner · (704) 516-6782
NPI enumeratedFebruary 6, 2017
Last updated in NPPESFebruary 6, 2017
Mailing address4328 Mount Hukee Ave, San Diego, CA 92117-4738

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