| Duperly Wright, Ma, Mft | |
|
4125 Blackford Ave Ste 245 San Jose CA 95117-1705 | |
| (408) 406-7698 | |
| Not Available |
| Full Name | Duperly Wright, Ma, Mft |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4125 Blackford Ave Ste 245, San Jose, California |
| Authorized Official Name and Position | Duperly Wright (OWNER) |
| Authorized Official Contact | 4084067698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Duperly Wright, Ma, Mft 4125 Blackford Ave Ste 245 San Jose CA 95117-1705 Ph: (408) 406-7698 | Duperly Wright, Ma, Mft 4125 Blackford Ave Ste 245 San Jose CA 95117-1705 Ph: (408) 406-7698 |
| NPI Number | 1568798429 |
|---|---|
| Provider Enumeration Date | 10/28/2009 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568798429 | NPI | - | NPPES |
| MFT46673 | Other | CA | BBSE |
| 11980213 | Other | CA | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MFT46673 (California) | Primary |
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