Provider Information for 1528250834
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Mr. SHAWN POLIVOI LMSW, LCSW
Sex: Male
NPI: 1528250834
Last Updated: 2015-02-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1528250834 | ||||||||||||||||
| Enumeration Date | 2007-08-10 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 27758 SANTA MARGARITA PKWY # 152 MISSION VIEJO, CA 92691-6709 United States Phone: | Fax: | ||||||||||||||||
| Primary Practice Address | 1441 CONSTITUTION BLVD SALINAS, CA 93906-3100 United States Phone: 831-755-4111 | Fax: | ||||||||||||||||
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