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

Revai Nicole Samuel

Individual provider Physician Assistant · NPI 1295308831

Revai Nicole Samuel is a Physician Assistant in Irvine, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2021
Specialties on file
3

Practice location Address checks out

14443 Culver Dr # 14443-A
Irvine, CA 92604-0343
Phone: (949) 767-8173
Fax: (888) 972-1812
Show map & directions

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

Additional practice locations (1)

  • 1608 S J St Fl 5, Tacoma, WA 98405-4930 — (253) 274-7505

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 62641 (CA)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1295308831
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 21, 2021
Last updated in NPPESAugust 16, 2024
Certification dateAugust 16, 2024

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