Provider Demographics
NPI:1972857233
Name:REED-DRAKE, SYLVIA (LMFT)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:REED-DRAKE
Suffix:
Gender:F
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:PO BOX 849
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92856-6849
Mailing Address - Country:US
Mailing Address - Phone:714-639-5546
Mailing Address - Fax:714-639-5037
Practice Address - Street 1:621 EAST CARNEGIE DRIVE SUITE 210
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-1323
Practice Address - Country:US
Practice Address - Phone:909-386-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71923106H00000X
171M00000X
CALMFT111650106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator