Provider Information for 1447538194
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Mrs. ANGELA POLK
Other Names:Other Name:Mrs. ANGELA VINCENT POLK LMFTSex: Female
NPI: 1447538194
Last Updated: 2024-05-15
Certification Date: 2024-05-15
Certification Date: 2024-05-15
Details
| Name | Value | ||||||||
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| NPI | 1447538194 | ||||||||
| Enumeration Date | 2011-07-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1919 MARKET ST UNIT 110 OAKLAND, CA 94607-2751 United States Phone: 510-395-5083 | Fax: | ||||||||
| Primary Practice Address | 2450 VALDEZ ST UNIT 612 OAKLAND, CA 94612-3163 United States Phone: 510-395-5083 | Fax: | ||||||||
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