Healthcare Provider Details

I. General information

NPI: 1689503542
Provider Name (Legal Business Name): TAYLOR LESLIE VICTORIA FERGUSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 N VENTURA RD
OXNARD CA
93030-3855
US

IV. Provider business mailing address

561 WINCHESTER DR
OXNARD CA
93036-1464
US

V. Phone/Fax

Practice location:
  • Phone: 714-202-0118
  • Fax:
Mailing address:
  • Phone: 805-231-8569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: