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NPI Code Detail

MEDICARE: AGNES WRIGHT CADC, CAS

MEDICARE: AGNES WRIGHT CADC, CAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor270002CNCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790987048
Entity Type Code : Individual
Provider Name (Legal Business Name) : AGNES WRIGHT CADC, CAS
Provider Business Mailing Address
First Line : 2445 W WHITES BRIDGE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93706-1225
Country : US
Telephone Number : 559-264-5096
Fax Number : 831-758-5127
Provider Business Practice Location Address
First Line : 2445 W WHITES BRIDGE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93706-1225
Country : US
Telephone Number : 559-264-5096
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 07/29/2019

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