| Revive 3.2 Wellness Nursing PC | |
|
10328 Reseda Blvd Northridge CA 91326-3433 | |
| (818) 634-0082 | |
| Not Available |
| Full Name | Revive 3.2 Wellness Nursing PC |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 10328 Reseda Blvd, Northridge, California |
| Authorized Official Name and Position | Dianne Kristine Palasio (NURSE PRACTITIONER/CEO) |
| Authorized Official Contact | 8186340082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive 3.2 Wellness Nursing PC 10328 Reseda Blvd Northridge CA 91326-3433 Ph: (818) 634-0082 | Revive 3.2 Wellness Nursing PC 10328 Reseda Blvd Northridge CA 91326-3433 Ph: (818) 634-0082 |
| NPI Number | 1295693588 |
|---|---|
| Provider Enumeration Date | 01/14/2026 |
| Last Update Date | 01/14/2026 |
| Certification Date | 01/14/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295693588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Primary |
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