Amanda Vy-Lyn Ferguson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA56863 Issued in CA

Practice address

814 Francisco St
Los Angeles, CA 90017-2530

Phone

(909) 576-9050

NPI assigned

Jun 12, 2019

Last updated

Jun 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1114586112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 N ROOSEVELT AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041926",
            "telephone_number": "909-576-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 FRANCISCO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900172530",
            "telephone_number": "909-576-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "AMANDA",
        "middle_name": "VY-LYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA56863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Ference
• Fereshteh Yousefzadeh, DDS, MSD, Inc (Brentwood Family Orthodontics)
• Sanaz Fereshteh, DDS
• Nicole Ferguson Maharaj, MS, RD, CDE
• Denise Ferguson-Wilson
• Bradford Ferguson
• Cheryl Ferguson
• Kathleen C Ferguson, DO
• Lakeina Ferguson
• Lyndsey Ann Ferguson

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.