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General NPI Number Information
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NPI Number | 1639029028
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Entity Type | Organization
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Legal Business Name | SONOMA MOON AND STAR MENTAL HEALTH INC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 813 W NAPA ST
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City | SONOMA
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State | CA
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Zip | 95476-6414
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Country | US
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Telephone | 707-200-1950
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Fax | 101-316-8818
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Provider Business Mailing Address
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Address Line | PO BOX 703
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City | SONOMA
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State | CA
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Zip | 95476-0703
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Country | US
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Telephone | 707-200-1950
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Fax | 707-316-8818
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Authorized Official
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Title or Position | OWNER
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Name | JEANIE CROSHAW
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Credential | DO
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Telephone | 281-414-7712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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