Individual
HALEY MOGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 ALTAIR AVE, LOMPOC, CA 93436-1424
(805) 415-4571
Mailing address
355 PARK ST, BUELLTON, CA 93427-9741
(805) 325-9423
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95315830
CA
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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