Provider Demographics
NPI:1093781338
Name:DREW, BRIAN JAMES (NP)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:DREW
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 DOWNS ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6109
Mailing Address - Country:US
Mailing Address - Phone:760-439-9132
Mailing Address - Fax:
Practice Address - Street 1:1300 RANCHO DEL ORO ROAD
Practice Address - Street 2:OCEANSIDE VA CLINIC
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056
Practice Address - Country:US
Practice Address - Phone:760-643-4472
Practice Address - Fax:760-643-2096
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453796101YP2500X
CA13320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional