Provider Demographics
NPI:1760428072
Name:WRIGHT, THERESE LOUISE (NP)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:LOUISE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5451 E LAS LOMAS ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4138
Mailing Address - Country:US
Mailing Address - Phone:562-498-5988
Mailing Address - Fax:562-826-5765
Practice Address - Street 1:3505 CADILLAC AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1429
Practice Address - Country:US
Practice Address - Phone:714-979-5680
Practice Address - Fax:714-668-9341
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA298467363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health