Healthcare Provider Details

I. General information

NPI: 1467404145
Provider Name (Legal Business Name): DARLENE SNYDER PT, PCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 SOUTH RICHMAN AVE
FULLERTON CA
92832
US

IV. Provider business mailing address

200 W SANTA ANA BLVD
SANTA ANA CA
92701-4134
US

V. Phone/Fax

Practice location:
  • Phone: 714-992-4292
  • Fax: 714-773-4130
Mailing address:
  • Phone: 714-347-0474
  • Fax: 714-347-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT15771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: