| Doctor Name: | MS. HANNAH INGERBORG JORGENSEN |
| NPI Number: | 1114107372 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MFT |
| License Number: | |
| Business Practice Address: | 646 N H St Lompoc, CA - 934364519 |
| Business Phone Number: | 8058651940 |
| Business Fax Number: | 8058651954 |
| Mailing Address: | 646 N H St, LOMPOC |
| State: | CA |
| Postal Code: | 934364519 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2007 |
| NPI Last Update Date: | 11/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0850X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Mental Health |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |