Healthcare Provider Details

I. General information

NPI: 1942934310
Provider Name (Legal Business Name): BRENDA MOGERE REGISTERED NURSE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 W 8TH ST STE 109
HANFORD CA
93230-4533
US

IV. Provider business mailing address

3057 N YALE WAY
HANFORD CA
93230-8573
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-2500
  • Fax: 559-582-0550
Mailing address:
  • Phone: 302-252-5636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95034306
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95109508
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: