National Provider Identifier Database

TARA CROCKETT, ACSW, PPSC – NPI #1093692972
School


Contact Information

TARA CROCKETT, ACSW, PPSC
9510 ELK GROVE FLORIN RD
ELK GROVE, CA95624-1801
Phone: 916-892-2533
Fax:
Website:
Specialty Taxonomy Code
* School 1041S0200X

* Indicates primary specialty

NPI Profile & details for TARA CROCKETT

NPI Number 1093692972
Credentials ACSW, PPSC
Entity Individual
Enumeration date 08/20/2025
Last updated 08/20/2025 - About 10 months ago
Sole proprietor1 No
Identifiers
  • CA License #: 119482
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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