Healthcare Provider Details

I. General information

NPI: 1396770053
Provider Name (Legal Business Name): BARBARA A SNYDER PA, C/NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 GUZZI LN STE D
SONORA CA
95370-5292
US

IV. Provider business mailing address

690 GUZZI LN STE D
SONORA CA
95370-5292
US

V. Phone/Fax

Practice location:
  • Phone: 209-532-1919
  • Fax: 209-532-1918
Mailing address:
  • Phone: 209-532-1919
  • Fax: 209-532-1918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: