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General NPI Number Information
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NPI Number | 1750655122
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Entity Type | Organization
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Legal Business Name | PHILLIP D. SNYDER PHD CLINICAL PSYCHOLOGIST A PROFESSIONAL CORP
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 1161 E COVINA BLVD
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City | COVINA
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State | CA
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Zip | 91724-1523
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Country | US
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Telephone | 909-908-4722
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Fax |
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Provider Business Mailing Address
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Address Line | 1928 FROSTBURG CIR
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City | CLAREMONT
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State | CA
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Zip | 91711-2977
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Country | US
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Telephone | 909-908-4722
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | PHILLIP SNYDER
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Credential | PH.D.
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Telephone | 909-908-4722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY9930
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License Number State | CA
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