Provider Demographics
NPI:1992967228
Name:WRIGHT, PRESTON JAMES (PHD)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:JAMES
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 CROW CANYON RD STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1583
Mailing Address - Country:US
Mailing Address - Phone:925-820-6280
Mailing Address - Fax:925-820-8482
Practice Address - Street 1:2723 CROW CANYON RD STE 205
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1583
Practice Address - Country:US
Practice Address - Phone:925-820-6280
Practice Address - Fax:925-820-8482
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical