Provider Demographics
NPI:1073298899
Name:WRIGHT, KRISHONDA
Entity type:Individual
Prefix:
First Name:KRISHONDA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 PARK AVE APT A
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-7659
Mailing Address - Country:US
Mailing Address - Phone:510-827-9958
Mailing Address - Fax:
Practice Address - Street 1:43213 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5826
Practice Address - Country:US
Practice Address - Phone:510-284-7057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst