Healthcare Provider Details

I. General information

NPI: 1427710656
Provider Name (Legal Business Name): MR. SID WRIGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SIDNEY WRIGHT

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 VICENTE ST
SAN FRANCISCO CA
94116-2923
US

IV. Provider business mailing address

812 MEDITERRANEAN LN
REDWOOD CITY CA
94065-1760
US

V. Phone/Fax

Practice location:
  • Phone: 415-681-3211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: