MEDICARE: EDWARD FERRERO

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	103T00000X	Psychologist	32838	CA

General Provider Information

NPI Number	:	1730550534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD FERRERO

Provider Business Mailing Address
First Line	:	1950 ADDISON ST
Second Line	:	SUITE 109
City	:	BERKELEY
State	:	CA
Zip	:	94704-1176
Country	:	US
Telephone Number	:	510-548-9716
Fax Number	:

Provider Business Practice Location Address
First Line	:	4865 OLD REDWOOD HWY STE 102
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-1415
Country	:	US
Telephone Number	:	707-890-6541
Fax Number	:	888-528-7464

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

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	09/09/2024

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Directions to “ EDWARD FERRERO ” Practice Location

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