Healthcare Provider Details

I. General information

NPI: 1609110337
Provider Name (Legal Business Name): JOYLYN TAMARA SPARKLES N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 MONTGOMERY BLVD NE APT 401
ALBUQUERQUE NM
87109-1433
US

IV. Provider business mailing address

6300 MONTGOMERY BLVD NE APT 401
ALBUQUERQUE NM
87109-1433
US

V. Phone/Fax

Practice location:
  • Phone: 949-690-7908
  • Fax:
Mailing address:
  • Phone: 949-690-7908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT 60264667
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: