Provider Demographics
NPI:1174821508
Name:FERGUSON, BECCA HART (MA, MS, MFT)
Entity Type:Individual
Prefix:
First Name:BECCA
Middle Name:HART
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MA, MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 OFFICE PARK DR
Mailing Address - Street 2:SUITE 380
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0404
Mailing Address - Country:US
Mailing Address - Phone:661-869-2610
Mailing Address - Fax:661-869-2611
Practice Address - Street 1:5251 OFFICE PARK DR
Practice Address - Street 2:SUITE 380
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0404
Practice Address - Country:US
Practice Address - Phone:661-869-2610
Practice Address - Fax:661-869-2611
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45945106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist