Provider Demographics
NPI:1417044892
Name:SNYDER, KIMBERLY ANN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:YOESEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 S .FARRELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-416-1360
Mailing Address - Fax:760-416-1362
Practice Address - Street 1:333 S .FARRELL DRIVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-416-1360
Practice Address - Fax:760-416-1362
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40786106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33BG62OtherMEDICAL
CA33BGGZOtherMEDICAL DPSS