Healthcare Provider Details

I. General information

NPI: 1750228698
Provider Name (Legal Business Name): JEREMIAH NATHANAEL WRIGHT LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 ELKSFORD AVE
IRVINE CA
92604-2452
US

IV. Provider business mailing address

40 ELKSFORD AVE
IRVINE CA
92604-2452
US

V. Phone/Fax

Practice location:
  • Phone: 714-717-1600
  • Fax:
Mailing address:
  • Phone: 714-717-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number22502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: