Healthcare Provider Details

I. General information

NPI: 1801665716
Provider Name (Legal Business Name): SAYCHELLE RINCON YOUNGBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 UTAH ST SE APT 2
ALBUQUERQUE NM
87108-4268
US

IV. Provider business mailing address

530 UTAH ST SE APT 2
ALBUQUERQUE NM
87108-4268
US

V. Phone/Fax

Practice location:
  • Phone: 678-670-7385
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number26018D
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT20230202
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: