Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 19938 | CA |
NPI | 1063792083 |
---|---|
Provider Name | Vanessa Wright |
First Address | San Diego, CA 92106-6173 |
Second Address | San Diego, CA 92106-6173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2011 |
Last Update Date | 03/05/2016 |