Provider Demographics
NPI:1932372455
Name:DRAKE, DEBBIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:KEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11716 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-3732
Mailing Address - Country:US
Mailing Address - Phone:530-889-6728
Mailing Address - Fax:530-886-2895
Practice Address - Street 1:11716 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3732
Practice Address - Country:US
Practice Address - Phone:530-889-6728
Practice Address - Fax:530-886-2895
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN499355101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN499355OtherRN