Active NPI
Jacob Revilla
- Basic Emergency Medical Technician
- San Jose, CA
National Provider Identifier
1255252375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- E170956
- Practice address
- 245 Bieber Dr
San Jose, CA 95123-3613 - Phone
- (408) 440-6480
- NPI assigned
- Jul 23, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | E170956 | CA | Primary |
Addresses
Primary practice location
245 Bieber Dr
San Jose, CA 95123-3613
Mailing address
245 Bieber Dr
San Jose, CA 95123-3613
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784764800000",
"number": "1255252375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 BIEBER DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951233613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 BIEBER DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951233613",
"telephone_number": "408-440-6480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVILLA",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-07-23",
"last_updated": "2026-07-23",
"certification_date": "2026-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medical Technician, Basic",
"state": "CA",
"license": "E170956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.