Healthcare Provider Details

I. General information

NPI: 1306978358
Provider Name (Legal Business Name): DONNIEAU EVE SNYDER LMFT, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 10/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 K ST
MODESTO CA
95354-1018
US

IV. Provider business mailing address

PO BOX 3614
MODESTO CA
95352-3614
US

V. Phone/Fax

Practice location:
  • Phone: 209-505-4339
  • Fax: 209-537-6940
Mailing address:
  • Phone: 209-505-4339
  • Fax: 209-537-6940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number45344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: