MEDICARE: BRISA REVILLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	E1722014	CA

General Provider Information

NPI Number	:	1992659866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRISA REVILLA

Provider Business Mailing Address
First Line	:	14022 ROCKENBACH ST
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-2463
Country	:	US
Telephone Number	:	626-991-9356
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 S FREMONT AVE BLDG A10
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91803-8800
Country	:	US
Telephone Number	:	626-759-9154
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	03/20/2026

Similar Medicare Providers

1306794490 — KAREN CASILLAS
Practice Location Address:

1000 S FREMONT AVE
ALHAMBRA, CA
91803-8800

Practice Phone: 626-759-9154
Practice Fax:

1134077878 — MILAGRO PATRICIA GARCIA
Practice Location Address:

1000 S FREMONT AVE STE 10100
ALHAMBRA, CA
91803-8800

Practice Phone: 626-349-3838
Practice Fax:

1194673871 — NIA CAROL AZIZ-HUGHES
Practice Location Address:

1000 S FREMONT AVE BLDG A10
ALHAMBRA, CA
91803-8800

Practice Phone: 626-349-3838
Practice Fax:

1790160273 — UNIVERSITY OF SOUTHERN CALIFORNIA
Practice Location Address:

1000 S FREMONT AVE , SUITE 10150
ALHAMBRA, CA
91803-8800

Practice Phone: 855-885-2600
Practice Fax: 626-457-4195

1558219709 — ABEL FLORES SANCHEZ
Practice Location Address:

1000 S FREMONT AVE BLDG A10
ALHAMBRA, CA
91803-8800

Practice Phone: 626-759-9154
Practice Fax:

1356297774 — DANIEL N/A CRUZ
Practice Location Address:

1000 S FREMONT AVE BLDG A10
ALHAMBRA, CA
91803-8800

Practice Phone: 626-349-3838
Practice Fax:

Directions to “ BRISA REVILLA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.