Individual
TERESA MOSQUEDA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-5181
(916) 784-5770
Mailing address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-5181
(916) 784-5770
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
R-7403
CA
207XP3100X
Pediatric Orthopaedic Surgery Physician
2012015967
MO
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
A106151
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
784611
ANTHEM BLUE CROSS BLUE SHIELD
MO
Enumeration date
05/18/2007
Last updated
01/10/2022
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