Provider Demographics
NPI:1164830022
Name:WRIGHT-FONG, TARYN (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:TARYN
Middle Name:
Last Name:WRIGHT-FONG
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 3RD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-3103
Mailing Address - Country:US
Mailing Address - Phone:415-813-2204
Mailing Address - Fax:177-267-5910
Practice Address - Street 1:795 FOLSOM ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1243
Practice Address - Country:US
Practice Address - Phone:415-813-2204
Practice Address - Fax:177-267-5910
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11416664103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst