Individual provider · Type 1 NPI

Ethan Mark Fergon

Counselor · Vallejo, CA

NPI number 1972383750 Active

Practice location

908 Tuolumne St
Vallejo, CA 94590-4641

Call (707) 648-8121 Map

Fax (707) 648-8129

Specialties and licenses

TaxonomyCodeLicense
Community Health Worker 172V00000XNone listed
Adult Companion 372600000XNone listed
Counselor Primary 101Y00000XNone listed

Counselor: 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.

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About NPI 1972383750

Ethan Mark Fergon's National Provider Identifier is 1972383750, issued on Sep 29, 2023. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Vallejo, CA. The record was last updated on May 5, 2025.