Healthcare Provider Details

I. General information

NPI: 1710213335
Provider Name (Legal Business Name): MARIZA DEBORAH SNYDER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4179 PIEDMONT AVE #210
OAKLAND CA
94611-5186
US

IV. Provider business mailing address

4179 PIEDMONT AVE #210
OAKLAND CA
94611-5186
US

V. Phone/Fax

Practice location:
  • Phone: 510-658-8740
  • Fax: 510-658-8762
Mailing address:
  • Phone: 510-658-8740
  • Fax: 510-658-8762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number31189
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: