Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | CA |
NPI | 1194373209 |
---|---|
Provider Name | Baylee Lyn Ferguson |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Bakersfield, CA 93313-2049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2019 |
Last Update Date | 01/09/2019 |