Provider Demographics
NPI:1073714572
Name:WRIGHT-AVESON, DIANA L (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:L
Last Name:WRIGHT-AVESON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:L
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:64 MARIETTA DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1840
Mailing Address - Country:US
Mailing Address - Phone:510-676-1923
Mailing Address - Fax:
Practice Address - Street 1:1301 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-4005
Practice Address - Country:US
Practice Address - Phone:628-217-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist