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NPI Code Detail

MEDICARE: JEANIE CROSHAW D.O.

MEDICARE: JEANIE CROSHAW D.O.
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
12084P0800XPsychiatry Physician20A15475CA

General Provider Information

NPI Number : 1659751337
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANIE CROSHAW D.O.
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 :
Provider Business Practice Location Address
First Line : 2100 NAPA VALLEJO HWY
Second Line :
City : NAPA
State : CA
Zip : 94558-6234
Country : US
Telephone Number : 707-253-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2015
Last Update Date : 03/18/2026

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Directions to “ JEANIE CROSHAW D.O.” Practice Location

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