Provider Demographics
NPI:1265846018
Name:WRIGHT, KALON (CSUDC)
Entity type:Individual
Prefix:MR
First Name:KALON
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:
Credentials:CSUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076
Mailing Address - Country:US
Mailing Address - Phone:801-707-9341
Mailing Address - Fax:
Practice Address - Street 1:56 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:LOA
Practice Address - State:UT
Practice Address - Zip Code:84747-0400
Practice Address - Country:US
Practice Address - Phone:435-836-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2025-03-05
Deactivation Date:2023-11-21
Deactivation Code:
Reactivation Date:2025-03-03
Provider Licenses
StateLicense IDTaxonomies
UT9024006-6005101YA0400X
CA1072281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)