| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KARLA MOGOLLAN | 1104548973 | 2022-09-16 |
Karla Mogollan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1104548973. Registration indicates Karla Mogollan is a provider of services with a specialization in Other Service Providers, Community Health Worker (Community Health Worker, ) (Community Health Worker, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Karla Mogollan |
| Practice Office Address | 1260 N DUTTON AVE STE 220 SANTA ROSA, CA US |
| Practice Office Telephone | 7075682300 |
| Mailing Address | 1260 N DUTTON AVE STE 220 SANTA ROSA, CA 954014686 US |
| Code | Practice | License No State |
|---|---|---|
| 172V00000X PRIMARY | Other Service Providers Community Health Worker Community Health Worker Community Health Worker Other Service Providers |