Healthcare Provider Details

I. General information

NPI: 1629983499
Provider Name (Legal Business Name): YOUYOU MAYUYU TEKETESSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 W CENTER ST APT 106
MANTECA CA
95337-4240
US

IV. Provider business mailing address

1483 W CENTER ST APT 106
MANTECA CA
95337-4240
US

V. Phone/Fax

Practice location:
  • Phone: 209-302-0169
  • Fax:
Mailing address:
  • Phone: 209-302-0169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: