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Organization

REVITALIZE WELLNESS CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAZIA TABASUM MALIK (NP)
(559) 507-3760
Entity
Organization

Contact information

Practice address
2501 W SHAW AVE STE 113, FRESNO, CA 93711-3307
(559) 507-3760
(539) 238-2199
Mailing address
5170 N FLOYD AVE, FRESNO, CA 93723-9435
(559) 507-3760
(539) 238-2199

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
10/18/2024
Last updated
04/14/2026
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