Healthcare Provider Details

I. General information

NPI: 1619822285
Provider Name (Legal Business Name): CAMELLIA WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2026
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

615 HEALDSBURG AVE UNIT 407
SANTA ROSA CA
95401-5171
US

V. Phone/Fax

Practice location:
  • Phone: 205-401-1530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number95040808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: