Provider Demographics
NPI:1326440793
Name:WRIGHT, REBECCA CHASE
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CHASE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 PARK VIEW DR
Mailing Address - Street 2:APT 302
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-4342
Mailing Address - Country:US
Mailing Address - Phone:405-323-5030
Mailing Address - Fax:
Practice Address - Street 1:616 PARK VIEW DR
Practice Address - Street 2:APT 302
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-4342
Practice Address - Country:US
Practice Address - Phone:405-323-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22043235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist