Healthcare Provider Details

I. General information

NPI: 1609771591
Provider Name (Legal Business Name): JANELL DONNETTE SNEED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12264 DURANGO CT
VICTORVILLE CA
92392-8067
US

IV. Provider business mailing address

12264 DURANGO CT
VICTORVILLE CA
92392-8067
US

V. Phone/Fax

Practice location:
  • Phone: 840-877-3446
  • Fax:
Mailing address:
  • Phone: 840-877-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number569938734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: