Provider Demographics
NPI:1265018741
Name:DREWRY, SAVANNAH JEAN
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:JEAN
Last Name:DREWRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 ANTIQUE ROSE WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-9505
Mailing Address - Country:US
Mailing Address - Phone:866-523-4286
Mailing Address - Fax:
Practice Address - Street 1:5463 RIVER RD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-9703
Practice Address - Country:US
Practice Address - Phone:209-534-5630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician