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General NPI Number Information
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NPI Number | 1497543185
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Entity Type | Organization
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Legal Business Name | REVEAL IT AESTHETICS AND WELLNESS, LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 33348 PENCIN RD
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City | MENIFEE
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State | CA
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Zip | 92584-9217
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Country | US
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Telephone | 951-265-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 28039 SCOTT RD STE D BOX 255
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City | MURRIETA
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State | CA
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Zip | 92563-7430
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TALIA CLATE
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Credential | NP
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Telephone | 951-265-2340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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