Provider Demographics
NPI:1417195041
Name:JANE MYERS DREW INC
Entity Type:Organization
Organization Name:JANE MYERS DREW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:MYERS
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-645-5907
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health