DR. ANDREA POLK (NPI# 1790899581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790899581 |
| Entity Type | Individual |
| Full Name | DR. ANDREA POLK |
| Credential | PH D |
| Practice Address |
80 Eureka Square Suite 124 Pacifica CA 94044 |
| Mailing Address |
80 Eureka Square Ste 124 Pacifica CA 94044 |
| Practice Telephone | 6503590711 |
| Practice Fax Number | 6507381246 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY11637 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VALUE OPTIONS | 164390 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518411073 | Andrea Polk | Nurse Practitioner | 1165 N Us Highway 421, Delphi, IN 46923-8722 | 2016-08-12 |
| 1265854723 | Andrea Brianna Polk | Specialist/Technologist | 12371 S Kirkwood Rd, Stafford, TX 77477-2836 | 2014-01-16 |
| 1427368208 | Andrea Marie Polk | Nurse Practitioner | 109 Us Highway 66 E, Tell City, IN 47586-2755 | 2010-10-14 |
| 1164555470 | Andrea Whitney Polk | Counselor | 3121 Brooklawn Campus Dr, Louisville, KY 40218-1282 | 2007-03-14 |
| Street Address |
80 EUREKA SQUARE SUITE 124 |
| City | PACIFICA |
| State | CA |
| Zip Code | 94044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134670730 | West Bay Sleep Lab | Clinical Medical Laboratory | 80 Eureka Square, Suite #218, Pacifica, CA 94044 | 2016-10-18 |
| 1295832491 | Jennifer Lynne Gilman | Marriage & Family Therapist | 80 Eureka Square, Suite 147, Pacifica, CA 94044-2603 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878818 | Megan Breanna Murphy | Behavior Technician | 352 Fairway Dr, Pacifica, CA 94044 | 2019-12-13 |
| 1033603360 | Aurelia Ann Mullen Spadini | Registered Nurse | 1467 Crespi Dr., Pacifica, CA 94044 | 2018-06-20 |
| 1306258595 | Kathy Marie Dodge | Marriage & Family Therapist | 243 Arroyo Drive, Pacifica, CA 94044 | 2014-05-22 |
| 1417367715 | Lisa Marie Lee | Nurse Practitioner | 340 Eureka Drive, Pacifica, CA 94044 | 2014-05-07 |
| 1730510306 | Erin Somers | Counselor | 435 Edgemar Avenue, Pacifica, CA 94044 | 2013-12-09 |
| 1730514761 | Lydia Mae Hernandez | Physical Therapy Assistant | 2400 Skyline Blvd, Apt G4, Pacifica, CA 94044 | 2013-09-10 |
| 1326483041 | Eddie B. Waldrup | Marriage & Family Therapist | 3976 24th Street, San Francisco, CA 94044 | 2013-05-08 |
| 1346593258 | Clarissa Laqui Dimacali | Nurse's Aide | 50 W. Manor Dr # 1393, Pacifica, CA 94044 | 2012-10-17 |
| 1164718581 | Jose Higareda Lopez | Counselor | 480 Manor Plaza, Pacifica, CA 94044 | 2011-06-23 |
| 1558693234 | Susanne Labarge | Acupuncturist | 1305 A Palmetto Ave, Pacifica, CA 94044 | 2010-02-05 |
| Find all providers in zip 94044 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497135248 | Maryann Elizabeth Pellino-benner | Psychologist | 106 San Jose Ave, Pacifica, CA 94044-2700 | 2015-06-08 |
| 1285805846 | Samuel Bardwell Smith | Psychologist | 1279 Linda Mar Shopping Ctr, Suite 112, Pacifica, CA 94044-3347 | 2008-03-21 |
| 1376751248 | Michael Allen Zulli | Psychologist | 340 Eureka Dr, Pacifica, CA 94044 | 2007-05-21 |
| 1962858084 | Ingrid Ammondson | Psychologist | 480 Manor Plz, Pacifica, CA 94044-1839 | 2016-05-07 |
| 1023233202 | Jeffrey Joseph Bruno | Psychologist | 80 Eureka Sq, Suite 215, Pacifica, CA 94044-2654 | 2007-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023867 | Watson, Sanchez, & Navarro Psychological Group | Psychologist | 270 E 7th St Ste 1c, Upland, CA 91786-6602 | 2020-11-08 |
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1982203568 | Gautami Polepally Ashok | Psychologist | 1234 W Chapman Ave Ste 203, Orange, CA 92868-2863 | 2020-10-23 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1588261580 | Pamela J Newman | Psychologist | 3737 Elderberry Gln, Escondido, CA 92025-7910 | 2020-10-04 |
| 1689271785 | Michelle Sullivan | Psychologist | 2419 44th Ave, San Francisco, CA 94116-2062 | 2020-10-02 |
| 1184231730 | Joanna Lesley Kaye | Psychologist | 3555 Rosecrans St Ste 114-212, San Diego, CA 92110-3231 | 2020-09-28 |
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1730795634 | Maya Boustani | Psychologist | 5441 Dundee Ct, Rancho Cucamonga, CA 91739-2604 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.