Healthcare Provider Details

I. General information

NPI: 1225297310
Provider Name (Legal Business Name): DEBORAH KAY SNYDER CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH KAY CLAYTON

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 WATSON WAY
VISTA CA
92083-7924
US

IV. Provider business mailing address

2260 WATSON WAY
VISTA CA
92083-7924
US

V. Phone/Fax

Practice location:
  • Phone: 760-599-1882
  • Fax: 760-599-1884
Mailing address:
  • Phone: 760-599-1882
  • Fax: 760-599-1884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA015130315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: