Healthcare Provider Details

I. General information

NPI: 1528852928
Provider Name (Legal Business Name): TYONNA ELISA SANCHEZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 DEBORAH RD SE STE 205
RIO RANCHO NM
87124-6619
US

IV. Provider business mailing address

8300 WYOMING BLVD NE APT 2523
ALBUQUERQUE NM
87113-2172
US

V. Phone/Fax

Practice location:
  • Phone: 505-750-0405
  • Fax:
Mailing address:
  • Phone: 505-930-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2025-1188
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: