Healthcare Provider Details

I. General information

NPI: 1245736099
Provider Name (Legal Business Name): JOSEPH EDWARD SNAPP LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 04/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S OREGON ST
YREKA CA
96097-3475
US

IV. Provider business mailing address

PO BOX 1016
HAPPY CAMP CA
96039-1016
US

V. Phone/Fax

Practice location:
  • Phone: 530-841-3141
  • Fax: 530-841-5150
Mailing address:
  • Phone: 530-493-1600
  • Fax: 530-493-1648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW79300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: