Ana Ruth Revilla, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A81029 Issued in CA

Practice address

701 E Channel St
Stockton, CA 95202-2628

Phone

(209) 944-4700

Fax

(209) 944-4727

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
  • NPI 1427110329
  Medicare reassignment NPD
• Scenic Faculty Medical Group, Inc.

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1275559411
  Medicare reassignment NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1265030886
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Waterford, CA
  • NPI 1528433588
  NPD
• Lumira Healthcare

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1649099151
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1083792501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952010779",
            "telephone_number": "209-373-2800",
            "fax_number": "209-373-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CHANNEL ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022628",
            "telephone_number": "209-944-4700",
            "fax_number": "209-944-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVILLA",
        "first_name": "ANA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A81029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Resendiz Rodriguez
• Reskychrist Non Emergency Medical Transportation
• Restorative Solutions
• Rizza Dabu Resus
• Brian Andrew Reuter, M.B.B.S.
• Maria Elisabet Revilla, PHD
• Analuisa Revolorio-Crespo
• Guadalupe Reyes Castaneda
• Lizbeth Reyes Rodriguez
• Ailan Adriel Reyes, PHARMD

• Pediatrics Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.