Healthcare Provider Details

I. General information

NPI: 1750114104
Provider Name (Legal Business Name): RUMELI LOTI SNYDER LCSW, PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 MACARTHUR BLVD
OAKLAND CA
94610-3965
US

IV. Provider business mailing address

1023 MACARTHUR BLVD
OAKLAND CA
94610-3965
US

V. Phone/Fax

Practice location:
  • Phone: 510-874-7152
  • Fax:
Mailing address:
  • Phone: 510-874-7152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number24864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: