Healthcare Provider Details

I. General information

NPI: 1790172328
Provider Name (Legal Business Name): CHAD SNYDER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 06/04/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13228 OVAL DR
WHITTIER CA
90602-3537
US

IV. Provider business mailing address

13228 OVAL DR
WHITTIER CA
90602-3537
US

V. Phone/Fax

Practice location:
  • Phone: 562-556-8110
  • Fax:
Mailing address:
  • Phone: 562-556-8110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number99994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: