Provider Demographics
NPI:1427767888
Name:SNYDER, CRYSTELLE
Entity type:Individual
Prefix:MS
First Name:CRYSTELLE
Middle Name:
Last Name:SNYDER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70694
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91117-7694
Mailing Address - Country:US
Mailing Address - Phone:818-414-5034
Mailing Address - Fax:
Practice Address - Street 1:12001 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5801
Practice Address - Country:US
Practice Address - Phone:818-414-5034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1043831041C0700X
CALCSW1277161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCSW1227716OtherBOARD OF BEHAVIORAL SCIENCES
CAASW104383OtherBOARD OF BEHAVIORAL SCIENCES