Individual
BROOKLYNE HAZENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4171 OCEANSIDE BLVD STE 109, OCEANSIDE, CA 92056-6008
(760) 216-6253
Mailing address
31775 NE WILSONVILLE RD, NEWBERG, OR 97132-7089
(503) 899-7922
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA62332
CA
Other
Enumeration date
02/21/2023
Last updated
05/28/2023
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