Provider Demographics
NPI:1770694317
Name:SNYDER, AMY CHRISTINE (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CHRISTINE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:CHRISTINE
Other - Last Name:WORRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:3511 CAMINO DEL RIO SOUTH
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-630-7793
Mailing Address - Fax:619-923-2773
Practice Address - Street 1:3511 CAMINO DEL RIO SOUTH
Practice Address - Street 2:SUITE 303
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-630-7793
Practice Address - Fax:619-923-2773
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43855106H00000X
CALMFT45928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43855OtherIMF