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General NPI Number Information
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NPI Number | 1093749004
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Entity Type | Individual
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Provider Name | MELISSA KAY CROCHET M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 1650 LOS GAMOS DR STE 300
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1850
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Country | US
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Telephone | 415-444-4440
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Fax | 415-492-6215
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Provider Business Mailing Address
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Address Line | 1650 LOS GAMOS DR STE 300
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1850
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Country | US
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Telephone | 415-444-4440
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Fax | 415-492-6215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | A53333
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | K4400
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K4400
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License Number State | TX
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