Provider Demographics
NPI:1649611922
Name:FERGUSON, SACHA JENKINS (NP)
Entity type:Individual
Prefix:MS
First Name:SACHA
Middle Name:JENKINS
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:
Practice Address - Street 1:3885 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3840
Practice Address - Country:US
Practice Address - Phone:415-529-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22658649163W00000X
NY338517363LF0000X
DC1041971363LF0000X
CA95020801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331946Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY00695941Medicaid
NY331058Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331978Medicare Oscar/Certification