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1902623325
ISREAL REVIVO
ROSEVILLE, CA
NPI
1902623325
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
Enumeration Date
2024-09-25
Last Update Date
2024-10-18
Business Address
ISREAL REVIVO
3400 DOUGLAS BLVD STE 170
ROSEVILLE, CA 95661-4281
Phone number: 818-406-6689
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Mailing Address
ISREAL REVIVO
10443 ARMINTA ST
SUN VALLEY, CA 91352-4109
Phone number: 818-406-6689
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