Provider Demographics
NPI:1578966552
Name:FERGUSON, JENNIFER JEAN (MS, LPC, LPCC, CPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MS, LPC, LPCC, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5053 ALMANOR DR
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-2606
Mailing Address - Country:US
Mailing Address - Phone:972-342-6005
Mailing Address - Fax:
Practice Address - Street 1:5053 ALMANOR DR
Practice Address - Street 2:
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94505-2606
Practice Address - Country:US
Practice Address - Phone:972-342-6005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70116101YP2500X
NVCP5958-R101YP2500X
CALPCC17622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional