Provider Demographics
NPI:1609500172
Name:DREWES, JEFFERY THOMAS
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:THOMAS
Last Name:DREWES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 CENTRAL AVE UNIT 4
Mailing Address - Street 2:
Mailing Address - City:BUELLTON
Mailing Address - State:CA
Mailing Address - Zip Code:93427-9487
Mailing Address - Country:US
Mailing Address - Phone:316-789-4515
Mailing Address - Fax:
Practice Address - Street 1:900 CALLE DE LOS AMIGOS
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4435
Practice Address - Country:US
Practice Address - Phone:805-883-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4458224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant