Revitalize Integrated Body Systems

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC30496 Issued in CA

Legal business name

REVITALIZE INTEGRATED BODY SYSTEMS

Practice address

1618 El Camino Real
Menlo Park, CA 94025-4112

Phone

(408) 295-9970

NPI assigned

Mar 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Angelique Waite, D.C.

Title

President

Phone

(408) 295-9970

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1124341813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254112",
            "telephone_number": "408-295-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254112",
            "telephone_number": "408-295-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE INTEGRATED BODY SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "WAITE",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-295-9970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navdeesh Kaur Sidhu Reiners, MD
• Reitman Physical Therapy
• Branden Conan Renfro, ASW, LSW
• Resilience Medical PC
• Reverent Partnership Counseling, a Licensed Clinical Social Worker Cor
• Tiffany Reyes
• Harrison Reynolds, PHARM.D.
• Andrea Rice, OT
• Jennifer Rich
• Elizabeth Page Richard

• Chiropractor in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.