Provider Demographics
NPI:1639467137
Name:FERGUSON, ERIN LEIGH
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LEIGH
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 PASEO CASTILLE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-9264
Mailing Address - Country:US
Mailing Address - Phone:805-630-9690
Mailing Address - Fax:
Practice Address - Street 1:5284 ADOLFO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-6787
Practice Address - Country:US
Practice Address - Phone:805-289-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist