Healthcare Provider Details

I. General information

NPI: 1255622403
Provider Name (Legal Business Name): JANET LEE SNYDER R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N. TORREY PINES RD. N107
LA JOLLA CA
92037
US

IV. Provider business mailing address

10666 N. TORREY PINES RD. N107
LA JOLLA CA
92037
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-3136
  • Fax: 858-554-3111
Mailing address:
  • Phone: 858-554-3136
  • Fax: 858-554-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number654009
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: