=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114129111
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WRIGHT INSTITUTE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9911 W PICO BLVD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90035-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-277-2796
-----------------------------------------------------
Fax | 310-277-8903
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9911 W PICO BLVD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90035-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-277-2796
-----------------------------------------------------
Fax | 310-277-8903
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. ALLEN M. YASSER
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 310-277-2796
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------