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General NPI Number Information
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NPI Number | 1649154469
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Entity Type | Individual
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Provider Name | DR. PATRICE FERGUSON
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 25919 GADING RD
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City | HAYWARD
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State | CA
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Zip | 94544-2725
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Country | US
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Telephone | 510-782-8424
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Fax |
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Provider Business Mailing Address
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Address Line | 13420 GLASGOW GREEN LN
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City | CHARLOTTE
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State | NC
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Zip | 28213-4279
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Country | US
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Telephone | 240-274-7599
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 306649
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License Number State | CA
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