Active NPI
Lilian A Revelle
- Behavior Analyst
- Millbrae, CA
National Provider Identifier
1962139154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1390 El Camino Real
Millbrae, CA 94030-1411 - Phone
- (714) 881-0427
- NPI assigned
- Aug 6, 2022
- Last updated
- Aug 6, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1390 El Camino Real
Millbrae, CA 94030-1411
Mailing address
1390 El Camino Real
Millbrae, CA 94030-1411
Phone (714) 881-0427
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": "1659744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659744000000",
"number": "1962139154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1390 EL CAMINO REAL",
"city": "MILLBRAE",
"state": "CA",
"postal_code": "940301411",
"telephone_number": "714-881-0427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 EL CAMINO REAL",
"city": "MILLBRAE",
"state": "CA",
"postal_code": "940301411",
"telephone_number": "714-881-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVELLE",
"first_name": "LILIAN",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-06",
"last_updated": "2022-08-06",
"certification_date": "2022-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.