Provider Demographics
NPI:1598498867
Name:SNYDER, LAUREN (PSYD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SNYDER
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 1:1264 W HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6679
Mailing Address - Country:US
Mailing Address - Phone:224-432-9360
Mailing Address - Fax:
Practice Address - Street 1:101 E REDLANDS BLVD STE 285
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4721
Practice Address - Country:US
Practice Address - Phone:909-283-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94025379390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program