Provider Demographics
NPI:1730256827
Name:POLLACK, DAVID STUART (PH D)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STUART
Last Name:POLLACK
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 TAYLOR BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2294
Mailing Address - Country:US
Mailing Address - Phone:925-688-8910
Mailing Address - Fax:
Practice Address - Street 1:391 TAYLOR BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2294
Practice Address - Country:US
Practice Address - Phone:925-688-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 9185103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist