MEDICARE: CINDY SUE FERGUSON LCSW

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
1	1041C0700X	Clinical Social Worker	LCS20225	CA

General Provider Information

NPI Number	:	1659332716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY SUE FERGUSON LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1565
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91944-1565
Country	:	US
Telephone Number	:	619-980-4797
Fax Number	:	619-980-4797

Provider Business Practice Location Address
First Line	:	7851 MISSION CENTER CT STE 110
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1326
Country	:	US
Telephone Number	:	619-980-4797
Fax Number	:	619-980-4797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	05/31/2025

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