Healthcare Provider Details

I. General information

NPI: 1891651592
Provider Name (Legal Business Name): CROW CANYON RESIDENTIAL CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2025
Last Update Date: 12/27/2025
Certification Date: 12/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2254 DOVER WAY
PITTSBURG CA
94565-4758
US

IV. Provider business mailing address

5 FAIRSIDE CT
PITTSBURG CA
94565-7342
US

V. Phone/Fax

Practice location:
  • Phone: 925-267-4489
  • Fax:
Mailing address:
  • Phone: 925-267-4489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. RUFFY BOLIVAR YU
Title or Position: ADMINISTRATOR/OWNER
Credential: DHA
Phone: 925-550-3117