Healthcare Provider Details

I. General information

NPI: 1639007263
Provider Name (Legal Business Name): REBECCA M BORREGO DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 244
SANTA CRUZ NM
87567-0244
US

IV. Provider business mailing address

PO BOX 244
SANTA CRUZ NM
87567-0244
US

V. Phone/Fax

Practice location:
  • Phone: 575-741-0989
  • Fax:
Mailing address:
  • Phone: 575-741-0989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number26023D
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: