Roxanne Polk, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

85857 Issued in CA

Practice address

404 Torrance Blvd
Redondo Beach, CA 90277-3325

Phone

(424) 250-0271

NPI assigned

Mar 22, 2015

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Octave Behavioral Health PC

  • Psychologist
  • San Francisco, CA
  • NPI 1184199549
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174917728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 ABRAHAM TER",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102467",
            "telephone_number": "310-941-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 TORRANCE BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773325",
            "telephone_number": "424-250-0271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24328 Vermont Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Harbor City",
            "state": "CA",
            "postal_code": "907102300",
            "country_code": "US",
            "telephone_number": "424-250-0271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "ROXANNE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "85857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Positive Energy Physical Therapy Inc

• Marriage & Family Therapist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.