Individual
VICTORIA RANTI BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4192 POLARIS AVE, LOMPOC, CA 93436-1250
(864) 551-5536
(805) 250-3248
Mailing address
4192 POLARIS AVE, LOMPOC, CA 93436-1250
(864) 551-5536
(805) 250-3248
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95016572
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95016572
CA
Other
Enumeration date
10/24/2016
Last updated
02/06/2026
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