Provider Demographics
NPI:1225248107
Name:DREW, JANE MYERS (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:MYERS
Last Name:DREW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SWIFT CT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-2302
Mailing Address - Country:US
Mailing Address - Phone:949-645-5907
Mailing Address - Fax:949-645-1686
Practice Address - Street 1:366 SAN MIGUEL DR
Practice Address - Street 2:SUITE 309
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7817
Practice Address - Country:US
Practice Address - Phone:949-645-5907
Practice Address - Fax:949-645-1686
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10077103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical