Provider Demographics
NPI:1780067967
Name:BRIGHT, DAWN (LVN, RCFE)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:LVN, RCFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-5227
Mailing Address - Country:US
Mailing Address - Phone:510-289-9202
Mailing Address - Fax:
Practice Address - Street 1:519 IOWA ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5227
Practice Address - Country:US
Practice Address - Phone:510-289-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA287936164W00000X, 164X00000X, 251B00000X, 251E00000X, 310400000X, 311500000X, 314000000X
CA5564237740310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility