Provider Demographics
NPI:1396861084
Name:WRIGHT, JUDY F (PHN)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:F
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 VAN HOUTEN AVE
Mailing Address - Street 2:STE. 204
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4429
Mailing Address - Country:US
Mailing Address - Phone:619-401-3685
Mailing Address - Fax:619-401-3886
Practice Address - Street 1:151 VAN HOUTEN AVE
Practice Address - Street 2:STE. 204
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4429
Practice Address - Country:US
Practice Address - Phone:619-401-3685
Practice Address - Fax:619-401-3886
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA563831163WC1500X, 163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA563831OtherRN LICENSE