Individual
BENAI FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT
Contact information
Practice address
3594 4TH AVE, SAN DIEGO, CA 92103-4940
(619) 296-1151
Mailing address
3594 4TH AVE, SAN DIEGO, CA 92103-4940
(619) 296-1151
(619) 296-6218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13684
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
03/01/2018
Last updated
06/28/2023
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