Individual
ALEXANDRA CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
710 S BROADWAY STE 300, WALNUT CREEK, CA 94596-5229
(925) 295-4145
Mailing address
512 43RD ST, RICHMOND, CA 94805-2354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
PSY30646
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2014
Last updated
01/03/2022
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