Individual provider Active NPI

Phillip D. Snyder, PH.D.

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1962563304
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9930 Issued in CA
Practice address
960 E Green St
Suite 202
Pasadena, CA 91106-2401
Phone
(626) 793-7792
Fax
(626) 793-7797
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY9930 CA Primary

Addresses

Primary practice location

960 E Green St
Suite 202
Pasadena, CA 91106-2401

Mailing address

960 E Green St
Suite 202
Pasadena, CA 91106-2401
Phone (626) 793-7792

Other identifiers 1

IdentifierTypeStateIssuer
PSY0099300MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120305000161 CA Practitioner - Psychologist Billing Independently 9234396532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1161 E Covina Blvd
Covina, CA 91724-1523
Phone (909) 261-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Phillip D. Snyder PHD Clinical Psychologist a Professional Corp Clinical CurrentSince Oct 29, 2011 Accepting new patients
Howard L Askins, a Medical Corporation PastSince Jan 1, 1996 Accepting new patients

Locations

1161 E Covina Blvd
Covina, CA 91724
Phone (626) 859-5289

415 W Route 66
Ste 202
Glendora, CA 91740

960 E Green St
Ste 202
Pasadena, CA 91106
Phone (626) 783-7792

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1962563304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST",
            "address_2": "SUITE 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062401",
            "telephone_number": "626-793-7792",
            "fax_number": "626-793-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST",
            "address_2": "SUITE 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062401",
            "telephone_number": "626-793-7792",
            "fax_number": "626-793-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "PHILLIP",
        "middle_name": "D.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY0099300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.