Provider Demographics
NPI:1215216106
Name:SNETTER, MIATTA RASCHEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MIATTA
Middle Name:RASCHEL
Last Name:SNETTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 CENTURY PARK E
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-1501
Mailing Address - Country:US
Mailing Address - Phone:310-229-5727
Mailing Address - Fax:
Practice Address - Street 1:1800 CENTURY PARK E
Practice Address - Street 2:SUITE 600
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-1501
Practice Address - Country:US
Practice Address - Phone:310-229-5727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24426103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical