Healthcare Provider Details

I. General information

NPI: 1013875178
Provider Name (Legal Business Name): QUYNH UONG CROTTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 SALVIO ST STE 200
CONCORD CA
94520-2193
US

IV. Provider business mailing address

PO BOX 1764
BETHEL ISLAND CA
94511-1764
US

V. Phone/Fax

Practice location:
  • Phone: 925-602-1750
  • Fax: 925-602-1754
Mailing address:
  • Phone: 916-835-1407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: