MEDICARE: TAYLOR LESLIE VICTORIA 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
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1689503542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR LESLIE VICTORIA FERGUSON

Provider Business Mailing Address
First Line	:	561 WINCHESTER DR
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93036-1464
Country	:	US
Telephone Number	:	805-231-8569
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 N VENTURA RD
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93030-3855
Country	:	US
Telephone Number	:	714-202-0118
Fax Number	:

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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