Healthcare Provider Details

I. General information

NPI: 1184585838
Provider Name (Legal Business Name): STEPHANIE CROTTY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 2ND STREET SUITE 102
SAN FRANCISCO CA
94107
US

IV. Provider business mailing address

625 2ND STREET SUITE 102
SAN FRANCISCO CA
94107
US

V. Phone/Fax

Practice location:
  • Phone: 844-472-5634
  • Fax:
Mailing address:
  • Phone: 844-472-5634
  • Fax: 844-333-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number839962
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: