Healthcare Provider Details

I. General information

NPI: 1093811333
Provider Name (Legal Business Name): ANNE B. SNYDER PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 REDWOOD HWY. SUITE 350
SAN RAFAEL CA
94903
US

IV. Provider business mailing address

7200 REDWOOD BLVD STE 200
NOVATO CA
94945-3247
US

V. Phone/Fax

Practice location:
  • Phone: 415-883-0803
  • Fax: 415-883-0803
Mailing address:
  • Phone: 415-893-4132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: