REINALD ALLEN REVILLA

TORRANCE, CA
NPI1821507716
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA  95007937)
Additional Taxonomies163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA  758060)
Enumeration Date2017-09-24
Last Update Date2019-01-22
Business Address
REINALD ALLEN REVILLA PMHNP
23700 CAMINO DEL SOL
TORRANCE, CA 90505
Phone number: 310-530-1151
Mailing Address
REINALD ALLEN REVILLA PMHNP
PO BOX 4570
PALOS VERDES PENINSULA, CA 90274-9607
Phone number: 424-400-7748