Healthcare Provider Details

I. General information

NPI: 1376369876
Provider Name (Legal Business Name): ANGELIKA DRAKE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2024
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 2ND AVE STE 200
MARINA CA
93933-6244
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-582-2100
  • Fax:
Mailing address:
  • Phone: 831-649-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: