Individual
LISA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT/CHT
Contact information
Practice address
555 SOQUEL AVE, 190, SANTA CRUZ, CA 95060
(831) 214-2984
Mailing address
555 SOQUEL AVE, 190, SANTA CRUZ, CA 95060
(831) 214-2984
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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