Individual
MS. REVONIA J TRUBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11905 SO CENTRAL AVE, #201, LOS ANGELES, CA 90059
(323) 566-6911
(323) 566-6896
Mailing address
4203 LEVELSIDE AVE, LAKEWOOD, CA 90712
(562) 421-4375
(323) 566-6896
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP 1160
CA
364SW0102X
Women's Health Clinical Nurse Specialist
Primary
202745
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0011600
—
CA
Enumeration date
02/22/2007
Last updated
09/11/2025
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