Individual provider Active NPI

Craig Dallas Snyder, PH.D.

  • Clinical Psychologist
  • Beverly Hills, CA
National Provider Identifier
1992889398
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15857 Issued in CA
Practice address
8730 Wilshire Blvd
Suite# 210
Beverly Hills, CA 90211-2716
Phone
(310) 612-0035
Fax
(310) 471-0035
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY15857 CA Primary

Addresses

Primary practice location

8730 Wilshire Blvd
Suite# 210
Beverly Hills, CA 90211-2716

Mailing address

2337 Roscomare Rd
#2-353
Los Angeles, CA 90077-1854
Phone (310) 612-0035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15857CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992889398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2337 ROSCOMARE RD",
            "address_2": "#2-353",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771854",
            "telephone_number": "310-612-0035",
            "fax_number": "310-471-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 WILSHIRE BLVD",
            "address_2": "SUITE# 210",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112716",
            "telephone_number": "310-612-0035",
            "fax_number": "310-471-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "CRAIG",
        "middle_name": "DALLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.