CORE REVIVE / SOUL REVIVE LLC is a nutrition support registered nurse in Petaluma, CA. CORE REVIVE / SOUL REVIVE LLC NPI is 1154826980. The provider is registered as an organization entity type and is a multiple single specialty group. The provider Is Doing Business As Core Revive.
The provider's business location address is:
16 QUEENS LN PETALUMA, CA ZIP 94952-047 Phone: (707) 559-5347
The provider's authorized official is Philip Anthony Diehl . The authorized official title is Partner and has the following contact phone number (415) 250-7118.
The enumeration date for this NPI number is 3/26/2018 and was last updated on 6/11/2019.
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 11/21/2025
NPI Synchronization or Removal
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