Provider Demographics
NPI:1841648961
Name:FERGUSON, PATRICIA LOPEZ (MFT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOPEZ
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4095 LINDITO LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1212
Mailing Address - Country:US
Mailing Address - Phone:805-689-7185
Mailing Address - Fax:
Practice Address - Street 1:4095 LINDITO LN
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1212
Practice Address - Country:US
Practice Address - Phone:805-689-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist