ANGELA IRENE DRAKE (PH.D.) – Clinical Neuropsychologist, NPI 1336112663

ANGELA IRENE DRAKE (PH.D.) is a healthcare provider. based in San diego, California. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PSY13616 (CA). The NPI Number for ANGELA IRENE DRAKE (PH.D.) is 1336112663

Main info

Female
34 Years Of Experience
Accepts Medicare Assignment
Name
ANGELA IRENE DRAKE (PH.D.)
NPI
1336112663
Phone
(858) 558-0109
Address
3023 FRIED AVE
Enumeration Date
8 February 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9167342011
Graduation Year
1992 (34 years ago)
PAC ID
0648544718
Group Practice PAC ID
8022922475
Professional Enrollment ID
I20170928001198
Address ID
CA958256525SA500XXAVEX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,434 CLINICAL PSYCHOLOGIST in CA

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Provider Addresses for ANGELA IRENE DRAKE (PH.D.)

  • 3023, Fried Avenue, University City, San Diego, San Diego County, California, 92122, United States

    SAN DIEGO, CA 921222234

    Phone: (858) 558-0109

    Type: Mailing

  • Bob Wilson Drive, San Diego, San Diego County, California, 92134, United States

    NEUROSCIENCES DEPARTMENT DVBIC NAVAL MEDICAL CENTER

    SAN DIEGO, CA 921343201

    Phone: (619) 532-5461

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-09-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170928001198IClinical PsychologistCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92122)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022922475View full group profile
NameSpecialtyState
Registered Dietitian Or Nutrition ProfessionalCA
Cardiovascular Disease (Cardiology)CA
H E M A T O L O G Y/ O N C O L O G YCA
Cardiovascular Disease (Cardiology)CA
Physical Therapist In Private PracticeCA
Family PracticeCA
U R O L O G YCA
-CA
Physical Therapist In Private PracticeCA
O P T O M E T R YCT

Reviews

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Frequently asked questions

Can I verify ANGELA IRENE DRAKE (PH.D.) with an NPI only?
You can start verification with NPI 1336112663 for ANGELA IRENE DRAKE (PH.D.), then check state licensing separately.
Does the file indicate ANGELA IRENE DRAKE (PH.D.) is practicing under active NPI?
Directory data currently reports ANGELA IRENE DRAKE (PH.D.) as active.
What is ANGELA IRENE DRAKE (PH.D.)'s primary classification?
Clinical Neuropsychologist is the headline specialty for ANGELA IRENE DRAKE (PH.D.) here. Clinical services aligned with this taxonomy classification.
What address line appears for ANGELA IRENE DRAKE (PH.D.)?
ANGELA IRENE DRAKE (PH.D.)'s geographic hint is San Diego, California in our summary view.
Why does ANGELA IRENE DRAKE (PH.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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