Revitalized Family Care

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

REVITALIZED FAMILY CARE

Practice address

673 Pauline CT
Sonora, CA 95370-5216

Phone

(209) 404-6746

NPI assigned

May 11, 2020

Organization subpart

No

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

Authorized official

Name

Dayna Iverson, FNP

Title

President

Phone

(209) 404-6746

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aurora Rosales, FNP

  • Family Nurse Practitioner
  • Oakdale, CA
  • NPI 1811486301
  NPD (past)

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1508488750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 WEBSTER RD",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953617850",
            "telephone_number": "209-404-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 PAULINE CT",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705216",
            "telephone_number": "209-404-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZED FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "DAYNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-404-6746",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert I. Reina, M.D.
• James K Reinhardt, CADC-CAS
• Resilience Counseling Center, Inc.
• Resiliency Village
• Ralph Edward Retherford, M.D.
• Susan Rezin, LMFT
• Sami Rhodes
• Richa Mishra DDS Inc.
• Richard a. Munger M.D.,Inc.
• Richard D. Emery DDS, Inc

• Family Nurse Practitioner in Sonora, CA
• Providers in Sonora, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.