Provider Demographics
NPI:1518213859
Name:DRAPER, JAMES STEWART (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEWART
Last Name:DRAPER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:STEWART
Other - Last Name:DRAPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:834 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1304
Mailing Address - Country:US
Mailing Address - Phone:775-232-5212
Mailing Address - Fax:775-323-2716
Practice Address - Street 1:834 WILLOW ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1304
Practice Address - Country:US
Practice Address - Phone:775-232-5212
Practice Address - Fax:775-323-2716
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0062103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVS11230Medicare UPIN