Provider Demographics
NPI:1649447863
Name:WRIGHT, TAMMY REBECCA (LAC)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:REBECCA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6413 ALEXANDRI CIR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3610
Mailing Address - Country:US
Mailing Address - Phone:760-613-0477
Mailing Address - Fax:
Practice Address - Street 1:6413 ALEXANDRI CIR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-3610
Practice Address - Country:US
Practice Address - Phone:760-613-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5262171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist