Healthcare Provider Details

I. General information

NPI: 1164008892
Provider Name (Legal Business Name): DANELLE ANGELICA DRAYTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 21ST ST
SACRAMENTO CA
95811-5216
US

IV. Provider business mailing address

7551 FREEPORT BLVD # 1067
SACRAMENTO CA
95832-1001
US

V. Phone/Fax

Practice location:
  • Phone: 916-443-3299
  • Fax:
Mailing address:
  • Phone: 515-494-9905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: