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General NPI Number Information
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NPI Number | 1124922406
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Entity Type | Organization
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Legal Business Name | UPSIDIAN CARE NETWORK, LLC
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 1128 HARMON PL STE 200
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-2074
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Country | US
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Telephone | 612-552-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 200 UNIVERSITY AVE SE UNIT 2403
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-2475
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Country | US
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Telephone | 612-552-3066
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | DR. YANEVE FONGE
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Credential | MD
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Telephone | 203-668-9057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State | NULL
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