Provider Demographics
NPI:1427174192
Name:DRAPER, NAOMI SCHAEFFER (MS PT CFP)
Entity type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:SCHAEFFER
Last Name:DRAPER
Suffix:
Gender:F
Credentials:MS PT CFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 917
Mailing Address - Street 2:
Mailing Address - City:WOODACRE
Mailing Address - State:CA
Mailing Address - Zip Code:94973-0917
Mailing Address - Country:US
Mailing Address - Phone:415-488-4823
Mailing Address - Fax:415-488-4879
Practice Address - Street 1:38 CRESCENT DRIVE
Practice Address - Street 2:
Practice Address - City:WOODACRE
Practice Address - State:CA
Practice Address - Zip Code:94973-0917
Practice Address - Country:US
Practice Address - Phone:415-488-4823
Practice Address - Fax:415-488-4879
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT179010OtherBLUE SHIELD
CAPTO179010Medicaid
CAOPT179010OtherBLUE SHIELD