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REVIVE SALON AND SPA
NPI 1619415072
Nurse Practitioner - Family in San Diego, CA

Active since February 06, 2017
5965 VILLAGE WAY, E207, SAN DIEGO, CA 92130(619) 293-7233 Get Directions Write a Review

NPPES record last updated: February 6, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revive Salon And Spa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVIVE SALON AND SPA (NPI 1619415072) is a healthcare organization registered as a family in San Diego, California and active in the NPI registry since February 2017. The organization lists Mary Lynn Elizabeth Eichert, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1619415072
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameREVIVE SALON AND SPA
Location Address5965 VILLAGE WAY, E207San Diego, CA 92130-2475
Mailing Address4328 Mount Hukee AveSan Diego, CA 92117-4738 · (704) 516-6782
Phone(619) 293-7233
Organization SubpartNo
Authorized OfficialMary Lynn Elizabeth EichertNurse Practitioner · (704) 516-6782
Enumeration DateFebruary 6, 2017
✔ NPI 1619415072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95005931
5965 VILLAGE WAY, San Diego, CA 92130
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN C. NOSTI, D.D.S. INC.
Dentist (General Practice)
5965 VILLAGE WAY, SUITE E-206
SAN DIEGO, CA 92130
San Diego County (858) 900-3541

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revive Salon And Spa's NPI number?

The NPI number for Revive Salon And Spa is 1619415072. It was assigned to this organization in the NPPES registry on February 6, 2017.

Where is Revive Salon And Spa located?

Revive Salon And Spa is located at 5965 Village Way E207, San Diego, CA 92130. The listed phone number is (619) 293-7233.

What is Revive Salon And Spa's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Revive Salon And Spa was last updated on February 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.