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NPI Code Detail

MEDICARE: TONIA MARIE FERGUSON

MEDICARE:   TONIA MARIE FERGUSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistAMFT119978CA

General Provider Information

NPI Number : 1407566946
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONIA MARIE FERGUSON
Provider Business Mailing Address
First Line : PO BOX 1752
Second Line :
City : APPLE VALLEY
State : CA
Zip : 92307-0034
Country : US
Telephone Number : 619-879-0025
Fax Number :
Provider Business Practice Location Address
First Line : 3160 CAMINO DEL RIO S
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3813
Country : US
Telephone Number : 619-879-0025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2022
Last Update Date : 11/23/2022

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Directions to “ TONIA MARIE FERGUSON ” Practice Location

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