Provider Demographics
NPI:1578043196
Name:DRAKEFORD, OLIVER (LMFT)
Entity Type:Individual
Prefix:MR
First Name:OLIVER
Middle Name:
Last Name:DRAKEFORD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 S ROBERTSON BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1642
Mailing Address - Country:US
Mailing Address - Phone:310-467-6210
Mailing Address - Fax:
Practice Address - Street 1:930 S ROBERTSON BLVD STE 501
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1642
Practice Address - Country:US
Practice Address - Phone:310-467-6210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104987106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty