Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Mark Fergon

Individual provider Community Health Worker · NPI 1972383750

Ethan Mark Fergon is a Community Health Worker in Vallejo, California. Licensed in California. Registered with an NPI since 2023.

Licensed in
CA
In the registry since
2023
Specialties on file
3

Practice location Address checks out

908 Tuolumne St
Vallejo, CA 94590-4641
Phone: (707) 648-8121
Fax: (707) 648-8129
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X (CA)
Community Health Worker Taxonomy 172V00000X (CA)
Adult Companion Taxonomy 372600000X

Record details

NPI number1972383750
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 29, 2023
Last updated in NPPESMay 5, 2025
Certification dateMay 5, 2025
Mailing address908 Tuolumne St, Vallejo, CA 94590-4641

Other providers in Vallejo