Core Revive / Soul Revive LLC
NPI 1154826980 · Nutrition Support Registered Nurse · Petaluma, CA
Core Revive / Soul Revive LLC is a Nutrition Support Registered Nurse organization in Petaluma, CA (NPI 1154826980).
Provider details
- NPI number
- 1154826980
- Entity type
- Organization
- Primary specialty
- Nutrition Support Registered NurseNursing Service Providers
- Organization subpart
- No
- Authorized official
- Philip Diehl, Partner(415) 250-7118
- License
- 846331 (CA)
Specialties & taxonomies
Nursing Service Providers
Nursing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Core Revive
Registry dates
- Enumerated
- 2018-03-26
- Last updated
- 2019-06-11
Frequently asked questions
- What is Core Revive / Soul Revive LLC's NPI number?
- Core Revive / Soul Revive LLC's National Provider Identifier (NPI) is 1154826980, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Core Revive / Soul Revive LLC?
- Core Revive / Soul Revive LLC is classified in the NPPES registry as Nutrition Support Registered Nurse (Nursing Service Providers).
- Where is Core Revive / Soul Revive LLC located?
- Core Revive / Soul Revive LLC's practice location on file with NPPES is 16 Queens Ln, Petaluma, CA 94952-1047.
- What is Core Revive / Soul Revive LLC's phone number?
- The practice phone number listed in the NPPES registry for Core Revive / Soul Revive LLC is (707) 559-5347.
- Who is the authorized official for Core Revive / Soul Revive LLC?
- The authorized official listed on Core Revive / Soul Revive LLC's NPPES record is Philip Diehl, Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Core Revive / Soul Revive LLC's NPI active?
- Yes — Core Revive / Soul Revive LLC's NPI (1154826980) is active in the NPPES registry as of the last update on 2019-06-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.