Basic Information
Provider Information
NPI: 1881730562
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DRAYSON
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1801 VICENTE ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941162923
CountryCode: US
TelephoneNumber: 4156823194
FaxNumber: 4156647094
Practice Location
Address1: 1801 VICENTE ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941162923
CountryCode: US
TelephoneNumber: 4156823194
FaxNumber: 4156647094
Other Information
ProviderEnumerationDate: 01/29/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XIMF45234CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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