Zola Myrtle Ferguson, PA-C
Individual provider Active NPI Medical Physician Assistant · Loomis, CA
NPI 1962475673 · NPPES record last updated Oct 29, 2014
Key facts
- NPI
- 1962475673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA23049 (CA)
- Practice address
- 3986 Maple LN
Loomis, CA 95650-9741 - Phone
- (775) 544-2621
- NPI assigned
- Feb 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140924000477 | CA | Order and Referring Only - Physician Assistant | 3173742111 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23049 | CA | MD | General Practice Dentistry |
| PA23049 | CA | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA23049 | CA | Yes |
Addresses
Primary practice location
3986 Maple LN
Loomis, CA 95650-9741
Mailing address
3986 Maple LN
Loomis, CA 95650-9741
Phone (775) 544-2621
Other providers in Loomis, CA
- Queen Diefenbacher
- Glenda Susan Dillingham
- Ken R Dixon
- Lori Dunn
- Claire Nicole Ferguson
- Dixie Fields
- Talitha Frankenberger
- Charlotte Fritz
- Sandra Jane Fritz
- Karen Lynn Fullerton
All providers in Loomis, CA · Medical Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.