Provider Demographics
NPI:1093811333
Name:SNYDER, ANNE B (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 REDWOOD BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3247
Mailing Address - Country:US
Mailing Address - Phone:415-893-4132
Mailing Address - Fax:
Practice Address - Street 1:4330 REDWOOD HWY.
Practice Address - Street 2:SUITE 350
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903
Practice Address - Country:US
Practice Address - Phone:415-883-0803
Practice Address - Fax:415-883-0803
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT5056225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PT50560Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID