Provider Demographics
NPI:1679759070
Name:WRIGHT, JOHN WERNER
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WERNER
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CARR ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4710
Mailing Address - Country:US
Mailing Address - Phone:831-768-8132
Mailing Address - Fax:831-768-7593
Practice Address - Street 1:10 CARR ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4710
Practice Address - Country:US
Practice Address - Phone:831-768-8132
Practice Address - Fax:831-768-7593
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health