Provider Demographics
NPI:1083862775
Name:SNYDER, ROSE ANNE (EDM, PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:ANNE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:EDM, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811A COLLEGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705
Mailing Address - Country:US
Mailing Address - Phone:510-847-0987
Mailing Address - Fax:855-673-2197
Practice Address - Street 1:2811 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2167
Practice Address - Country:US
Practice Address - Phone:510-847-0987
Practice Address - Fax:855-673-2197
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24253103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist