Provider Demographics
NPI:1578306486
Name:FERGUSON, WENDY (LMFT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31414 POLO CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-7411
Mailing Address - Country:US
Mailing Address - Phone:619-335-7224
Mailing Address - Fax:
Practice Address - Street 1:27349 JEFFERSON AVE STE 101102
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5634
Practice Address - Country:US
Practice Address - Phone:951-296-9606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist