Provider Demographics
NPI:1558355669
Name:WRIGHT, ROBERT J (MA MFT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2304
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92088-2304
Mailing Address - Country:US
Mailing Address - Phone:760-723-3256
Mailing Address - Fax:760-723-8656
Practice Address - Street 1:40680 CALIFORNIA OAKS RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5755
Practice Address - Country:US
Practice Address - Phone:951-693-4228
Practice Address - Fax:760-723-8656
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT31742106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist