Provider Demographics
NPI:1851860944
Name:WRIGHT, PAMELA RENEE (BSW, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RENEE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:BSW, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8368 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1734
Mailing Address - Country:US
Mailing Address - Phone:626-394-5333
Mailing Address - Fax:
Practice Address - Street 1:8368 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1734
Practice Address - Country:US
Practice Address - Phone:626-394-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-18
Last Update Date:2018-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS230761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty