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NPI Code Detail

MEDICARE: SONOMA MOON AND STAR MENTAL HEALTH INC

MEDICARE: SONOMA MOON AND STAR MENTAL HEALTH INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician
22084A0401XAddiction Medicine (Psychiatry & Neurology) Physician
32084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1639029028
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONOMA MOON AND STAR MENTAL HEALTH INC
Provider Business Mailing Address
First Line : PO BOX 703
Second Line :
City : SONOMA
State : CA
Zip : 95476-0703
Country : US
Telephone Number : 707-200-1950
Fax Number : 707-316-8818
Provider Business Practice Location Address
First Line : 813 W NAPA ST
Second Line :
City : SONOMA
State : CA
Zip : 95476-6414
Country : US
Telephone Number : 707-200-1950
Fax Number : 101-316-8818
Authorized Official
Title or Position : OWNER
Name : JEANIE CROSHAW
Credential : DO
Telephone Number : 281-414-7712
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/09/2026

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Directions to “SONOMA MOON AND STAR MENTAL HEALTH INC ” Practice Location

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