Healthcare Provider Details

I. General information

NPI: 1851214548
Provider Name (Legal Business Name): REVITAL GLOW AESTHETICS & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6810 FIVE STAR BLVD STE 300
ROCKLIN CA
95677-2698
US

IV. Provider business mailing address

6810 FIVE STAR BLVD STE 300
ROCKLIN CA
95677-2698
US

V. Phone/Fax

Practice location:
  • Phone: 916-584-6037
  • Fax:
Mailing address:
  • Phone: 916-584-6037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NAKISHA SATTELMAIER
Title or Position: NURSE PRACTITIONER, OWNER
Credential:
Phone: 253-468-5704