Healthcare Provider Details

I. General information

NPI: 1548758287
Provider Name (Legal Business Name): COURTNEY B DRAPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2018
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10850 MACARTHUR BLVD
OAKLAND CA
94605-5266
US

IV. Provider business mailing address

10850 MACARTHUR BLVD STE 200
OAKLAND CA
94605-5266
US

V. Phone/Fax

Practice location:
  • Phone: 510-661-3183
  • Fax:
Mailing address:
  • Phone: 510-875-2300
  • Fax: 510-875-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number21249
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: