Provider Demographics
NPI:1376006098
Name:SNYDER, JANICE DEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:DEE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BUGGY WHIP DR
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90274-5008
Mailing Address - Country:US
Mailing Address - Phone:310-377-2199
Mailing Address - Fax:
Practice Address - Street 1:3400 LOMITA BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4900
Practice Address - Country:US
Practice Address - Phone:310-377-2199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT8880103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling