Individual provider Active NPI

Natasha Revilla, MS, LMFT

  • Marriage & Family Therapist
  • Hemet, CA
National Provider Identifier
1033572086
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT91215 Issued in CA
Practice address
132 S Thompson St
Hemet, CA 92543
Phone
(951) 390-7575
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT91215 CA Primary

Addresses

Primary practice location

132 S Thompson St
Hemet, CA 92543

Mailing address

132 S Thompson St
Hemet, CA 92543-4351
Phone (951) 390-7575

Other practice location 1

29748 Rancho California Rd
Temecula, CA 92591-5286
Phone (951) 694-0695

Other practice location 2

650 N State St
Hemet, CA 92543-2960
Phone (951) 791-3342

Other practice location 3

650 N State St
Hemet, CA 92543-2960
Phone (951) 791-3342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LMFT91215CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Novell & Novell Counseling Marriage & Family Therapist PastSince Jan 30, 2017 Accepting new patients
Novell & Novell Counseling Services, Inc. Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1033572086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S THOMPSON ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434351",
            "telephone_number": "951-390-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S THOMPSON ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "951-390-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29748 Rancho California Rd",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925915286",
            "country_code": "US",
            "telephone_number": "951-694-0695",
            "fax_number": "951-695-6215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 N State St",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925432960",
            "country_code": "US",
            "telephone_number": "951-791-3342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 N State St",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925432960",
            "country_code": "US",
            "telephone_number": "951-791-3342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVILLA",
        "first_name": "NATASHA",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT91215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.