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Organization
REVIVE 3.2 WELLNESS NURSING PC
Active
Organization
REVIVE 3.2 WELLNESS NURSING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANNE KRISTINE PALASIO NP (NURSE PRACTITIONER/CEO)
(818) 634-0082
Entity
Organization
Contact information
Practice address
10328 RESEDA BLVD, NORTHRIDGE, CA 91326-3433
(818) 634-0082
Mailing address
10328 RESEDA BLVD, NORTHRIDGE, CA 91326-3433
(818) 634-0082
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/14/2026
Last updated
01/14/2026
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