Vida Revival LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VIDA REVIVAL LLC

Practice address

3180 Willow LN Ste 114
Thousand Oaks, CA 91361-4984

Phone

(818) 232-8432

Fax

(818) 232-8433

NPI assigned

Feb 6, 2025

Organization subpart

No

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

Authorized official

Name

Diana AlaviNPI 1700276680

Title

Owner

Phone

(818) 232-8432

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana Alavi

  • Internal Medicine Physician
  • Thousand Oaks, CA
  • NPI 1700276680
  NPD Authorized official

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1952115149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 114",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614984",
            "telephone_number": "818-232-8432",
            "fax_number": "818-232-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 114",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614984",
            "telephone_number": "818-232-8432",
            "fax_number": "818-232-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA REVIVAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "ALAVI",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-232-8432"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Kishore Verma, AMFT
• Rachel Veroni Wooff
• Destiny Verrette
• Hadley Veselak, NP
• Vesper Healthcare, Inc. (Buena Vista Hospice)
• Vida Revival Medical Corporation
• Michelle Carino Viernes, MD, BSMT
• Vigilance Healthcare Inc.
• Vigilance Medical Corporation
• Kimberly Villa

• Internal Medicine Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.