Individual
DR. ANDREA POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
80 EUREKA SQUARE, SUITE 124, PACIFICA, CA 94044
(650) 359-0711
(650) 738-1246
Mailing address
80 EUREKA SQUARE, STE 124, PACIFICA, CA 94044
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY11637
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164390
VALUE OPTIONS
—
Enumeration date
08/18/2006
Last updated
07/08/2007
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