Larisa M Revzina, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN555478 Issued in CA

Practice address

225 San Antonio Rd
Mountain View, CA 94040-1209

Phone

(650) 948-0804

Fax

(650) 948-3319

NPI assigned

Aug 30, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730299645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 HOLT AVE",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940246929",
            "telephone_number": "650-940-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SAN ANTONIO RD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940401209",
            "telephone_number": "650-948-0804",
            "fax_number": "650-948-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVZINA",
        "first_name": "LARISA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN555478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Mountain View, CA
• Providers in Mountain View, 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 Jul 8, 2007; 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.