Provider Demographics
NPI:1245446129
Name:WRIGHT, ROBERT C (PHD, LAC, DNBAO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHD, LAC, DNBAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 TRANCAS ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2942
Mailing Address - Country:US
Mailing Address - Phone:707-255-5124
Mailing Address - Fax:707-226-1303
Practice Address - Street 1:935 TRANCAS ST STE 4A
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2942
Practice Address - Country:US
Practice Address - Phone:707-255-5124
Practice Address - Fax:707-226-1303
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3711171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA0037110OtherBLUE SHIELD PPO