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Individual

DR. STEPHEN DREW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
750 LAS GALLINAS AVE STE 203, SAN RAFAEL, CA 94903-3432
(415) 491-4859
Mailing address
PO BOX 6121, SAN RAFAEL, CA 94903-0121
(415) 491-4859

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY12302
CA
103T00000X
Psychologist
PSY12302
CA
103TA0700X
Adult Development & Aging Psychologist
PSY12302
CA
103TB0200X
Cognitive & Behavioral Psychologist
PSY12302
CA
103TC0700X
Clinical Psychologist
PSY12302
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY12302
CA
103TF0000X
Family Psychologist
PSY12302
CA
103TH0100X
Health Service Psychologist
PSY12302
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PSY12302
CA
103TP2701X
Group Psychotherapy Psychologist
PSY12302
CA
103TR0400X
Rehabilitation Psychologist
PSY12302
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PSY123020
CA
Enumeration date
03/15/2007
Last updated
02/06/2012
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