Provider Demographics
NPI:1770203390
Name:WRIGHT, LENAE (ACSW)
Entity type:Individual
Prefix:
First Name:LENAE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:
Other - Last Name:RUSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACSW
Mailing Address - Street 1:1000 SUNSET BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5482
Mailing Address - Country:US
Mailing Address - Phone:916-517-5877
Mailing Address - Fax:
Practice Address - Street 1:1000 SUNSET BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5482
Practice Address - Country:US
Practice Address - Phone:916-517-5877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1086971041C0700X
CA108687104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical