Healthcare Provider Details

I. General information

NPI: 1710277462
Provider Name (Legal Business Name): MELISSA GEORGENSON DRAKE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 W PUEBLO ST STE B
SANTA BARBARA CA
93105-6206
US

IV. Provider business mailing address

227 CONSTANCE LN
SANTA BARBARA CA
93105-3519
US

V. Phone/Fax

Practice location:
  • Phone: 805-455-6500
  • Fax:
Mailing address:
  • Phone: 805-570-3694
  • Fax: 805-665-3736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number138505
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA138505
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: