Individual
WANDA GALE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
7200 BANCROFT AVE # 204, OAKLAND, CA 94605-2403
(510) 577-3517
Mailing address
1633 ALCATRAZ AVE, BERKELEY, CA 94703-2611
(216) 333-9678
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
580416
CA
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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