Healthcare Provider Details

I. General information

NPI: 1366566945
Provider Name (Legal Business Name): PATRICIA ELLEN DRAKE RN, BSN, PHN, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 BRESLAUER WAY
REDDING CA
96001-4246
US

IV. Provider business mailing address

2640 BRESLAUER WAY
REDDING CA
96001-4246
US

V. Phone/Fax

Practice location:
  • Phone: 530-245-6402
  • Fax:
Mailing address:
  • Phone: 530-245-6402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number03-034848
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN397514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: