Active NPI
Vitam Revivere Corporation
- Psychologist
- Woodland, CA
National Provider Identifier
1164070009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- VITAM REVIVERE CORPORATION
- Practice address
- 327 College St Ste 206
Woodland, CA 95695-3484 - Phone
- (916) 288-7484
- NPI assigned
- Sep 3, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Donald Robert Siggins, ED.D.
- Title
- Psychologist
- Phone
- (530) 591-7284
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
327 College St Ste 206
Woodland, CA 95695-3484
Mailing address
327 College St Ste 206
Woodland, CA 95695-3484
Phone (916) 288-7484
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346665361 | Other | CA | NPI |
| 1760860100 | Other | CA | NPI |
National Provider Directory
National Provider DirectoryLocations
327 College St
Ste 206
Woodland, CA 95695
Phone (530) 591-7284
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Child & Adolescent Psychologist
- Woodland, CA
- NPI 1346665361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1567468800000",
"number": "1164070009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 COLLEGE ST STE 206",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956953484",
"telephone_number": "916-288-7484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 COLLEGE ST STE 206",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956953484",
"telephone_number": "916-288-7484"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VITAM REVIVERE CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-03",
"last_updated": "2019-09-03",
"status": "A",
"authorized_official_last_name": "SIGGINS",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "ROBERT",
"authorized_official_title_or_position": "PSYCHOLOGIST",
"authorized_official_telephone_number": "530-591-7284",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "ED.D."
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1346665361",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1760860100",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.