Provider Demographics
NPI:1457177461
Name:SNYDER, GRIFFIN (PPS SCHOOL PSYCH)
Entity type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:SNYDER
Suffix:
Gender:M
Credentials:PPS SCHOOL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 9TH ST APT 204
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1358
Mailing Address - Country:US
Mailing Address - Phone:559-410-1885
Mailing Address - Fax:
Practice Address - Street 1:1415 OAKLAND BLVD STE 203
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4395
Practice Address - Country:US
Practice Address - Phone:925-378-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4644103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool