Individual
MRS. HEATHER LANAINA MOMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
40077
MT
363LP0200X
Pediatric Nurse Practitioner
Primary
95040663
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2210068
—
MT
05
—
THP11576F
—
CA
Enumeration date
04/20/2011
Last updated
07/22/2026
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