Provider Demographics
NPI:1255886867
Name:CLEMONS SNOWDEN, BEVERLY A (LMFT)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:A
Last Name:CLEMONS SNOWDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34535 CRENSHAW ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-7449
Mailing Address - Country:US
Mailing Address - Phone:909-578-2264
Mailing Address - Fax:
Practice Address - Street 1:300 PULLMAN ST BLDG B
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-9756
Practice Address - Country:US
Practice Address - Phone:510-618-5990
Practice Address - Fax:925-294-7202
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA108013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist