Basic Information
| Provider Information | |||||||||
| NPI: | 1093347353 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | YASMIN | ||||||||
| MiddleName: | JAMIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1273 BOURET DR UNIT 4 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951182613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087750723 | ||||||||
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| Practice Location | |||||||||
| Address1: | 102 S 11TH ST | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951122132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4089985191 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2020 | ||||||||
| LastUpdateDate: | 02/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | R1336230119 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.