Provider Demographics
NPI:1972667095
Name:CROMMIE, SONIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:
Last Name:CROMMIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 CHESTNUT ST
Mailing Address - Street 2:SUITE #11
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-328-7435
Mailing Address - Fax:650-321-6920
Practice Address - Street 1:1149 CHESTNUT ST
Practice Address - Street 2:SUITE #11
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-328-7435
Practice Address - Fax:650-321-6920
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS44151041C0700X
CAABE 3625 BCD1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ78478ZMedicare UPIN