1629144423 NPI number — MS. VALERIE GAIL FERGUSON MSW LCSW DCSW

Table of content: MS. VALERIE GAIL FERGUSON MSW LCSW DCSW (NPI 1629144423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629144423 NPI number — MS. VALERIE GAIL FERGUSON MSW LCSW DCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERGUSON
Provider First Name:
VALERIE
Provider Middle Name:
GAIL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LCSW DCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLAGG
Provider Other First Name:
VALERIE
Provider Other Middle Name:
GAIL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1629144423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20720 VENTURA BLVD
Provider Second Line Business Mailing Address:
SUITE 120 VALERIE FERGUSON MSW DCSW
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91364
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-348-5180
Provider Business Mailing Address Fax Number:
818-348-5339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20720 VENTURA BLVD
Provider Second Line Business Practice Location Address:
SUITE 120 VALERIE FERGUSON MSW DCSW
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-348-5180
Provider Business Practice Location Address Fax Number:
818-348-5339
Provider Enumeration Date:
11/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  6072 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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