Provider Demographics
NPI:1851829931
Name:WRIGHT, ROSA PEREZ (MHS, PA-C)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:PEREZ
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 FAIR OAKS AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3929
Mailing Address - Country:US
Mailing Address - Phone:805-434-5530
Mailing Address - Fax:805-434-0023
Practice Address - Street 1:350 POSADA LN STE 202
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4060
Practice Address - Country:US
Practice Address - Phone:805-434-5497
Practice Address - Fax:805-434-0917
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA54401363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA54401OtherCALIFORNIA PHYSICIAN ASSISTANT LICENSE