Healthcare Provider Details

I. General information

NPI: 1316163801
Provider Name (Legal Business Name): SHERYLE ANN FERGUSON M.A., MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N R ST STE 117
MADERA CA
93637-4465
US

IV. Provider business mailing address

PO BOX 1288
MADERA CA
93639-1288
US

V. Phone/Fax

Practice location:
  • Phone: 559-395-0450
  • Fax: 559-661-2818
Mailing address:
  • Phone: 559-395-0450
  • Fax: 559-661-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC44104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: