Healthcare Provider Details

I. General information

NPI: 1366925117
Provider Name (Legal Business Name): CHRISTINE MARIE DRAPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 GARDEN RD STE 200-C
MONTEREY CA
93940-5373
US

IV. Provider business mailing address

311 PINE AVE
PACIFIC GROVE CA
93950-3501
US

V. Phone/Fax

Practice location:
  • Phone: 831-250-6770
  • Fax: 831-250-6767
Mailing address:
  • Phone: 520-907-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License NumberCA2411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: