Active NPI
Thomas Revell
- Occupational Therapist
- San Diego, CA
National Provider Identifier
1053798249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 15258
- Practice address
- 4100 Normal St
San Diego, CA 92103-2653 - Phone
- (619) 725-5501
- NPI assigned
- Apr 27, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 15258 | CA | Primary |
Addresses
Primary practice location
4100 Normal St
San Diego, CA 92103-2653
Mailing address
2890 Silver Medal Rd Unit 1
Chula Vista, CA 91915-2667
Other practice location 1
260 E Chase Ave Ste 204
El Cajon, CA 92020-6300
Phone (619) 647-6157
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15258 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774224000000",
"number": "1053798249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2890 SILVER MEDAL RD UNIT 1",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919152667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 NORMAL ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032653",
"telephone_number": "619-725-5501"
}
],
"practiceLocations": [
{
"address_1": "260 E Chase Ave Ste 204",
"address_purpose": "LOCATION",
"city": "El Cajon",
"state": "CA",
"postal_code": "920206300",
"country_code": "US",
"telephone_number": "619-647-6157",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REVELL",
"first_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-27",
"last_updated": "2026-03-23",
"certification_date": "2026-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "15258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.