Provider Demographics
NPI:1053444554
Name:SNOW, SHERYL DIANE (MED, CADC-II, LMFT)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:DIANE
Last Name:SNOW
Suffix:
Gender:F
Credentials:MED, CADC-II, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42455 10TH ST W STE 101
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-7060
Mailing Address - Country:US
Mailing Address - Phone:310-735-1766
Mailing Address - Fax:
Practice Address - Street 1:42455 10TH ST W STE 101
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7060
Practice Address - Country:US
Practice Address - Phone:310-735-1766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA52989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist