Crossleysmith, Virginia Marie

Crossleysmith, Virginia Marie is an sole proprietor health care provider with primary practice located at 1212 College Ave Suite A, Santa Rosa CA 95404-3908. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Crossleysmith, Virginia Marie can be contacted via phone (707) 431-7579.

Contact Information

Primary practice address
1212 College Ave Suite A Santa Rosa CA 95404-3908
Phone: (707) 431-7579
Fax: (707) 843-5095
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 23799 California

Profile Details

NPI number 1538130356
LBN Legal business name Crossleysmith, Virginia Marie
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2006
Last updated Nov 1st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538130356 NPPES
California Other 23799 LICENSE NUMBER

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