ETHAN MARK FERGON
NPI 1972383750
Counselor in Vallejo, CA
- Individual
- Male
- Counselor
About ETHAN FERGON
This page provides the complete NPI Profile along with additional information for Ethan Fergon, a provider established in Vallejo, California with a medical specialization in Counselor. The healthcare provider is registered in the NPI registry with number 1972383750 assigned on September 2023. The practitioner's primary taxonomy code is 101Y00000X. The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1972383750 Verify this NPI
- Provider Name
- ETHAN MARK FERGON
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 908 TUOLUMNE ST VALLEJO, CA 94590
- Location Phone
- (707) 648-8121
- Location Fax
- (707) 648-8129
- Mailing Address
- 908 TUOLUMNE ST VALLEJO, CA 94590
- Mailing Phone
- (707) 648-8121
- Mailing Fax
- (707) 648-8129
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-29-2023
- Last Update Date
- 05-05-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor
- Taxonomy Code
- 101Y00000X
- Type
- Behavioral Health & Social Service Providers
- License State
- CA
- Taxonomy Description
- A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 172V00000X | Other Service Providers | Community Health Worker | (CA) |
| 2 | 372600000X | Nursing Service Related Providers | Adult Companion |
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The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972383750, enumerated as an "individual" on September 29, 2023.
The provider is located at 908 TUOLUMNE ST VALLEJO, CA 94590 and the phone number is (707) 648-8121.
Counselor with taxonomy code 101Y00000X.
