Evelyn Polk, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT30084 Issued in CA

Practice address

312 Georgia St
Suite #225
Vallejo, CA 94590-5964

Phone

(707) 553-1971

Fax

(707) 553-1969

NPI assigned

Jul 8, 2011

Last updated

Jul 8, 2011By 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

State licenses

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1225325376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 ROBLES WAY",
            "address_2": "#168",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918039",
            "telephone_number": "707-553-1971",
            "fax_number": "707-553-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 GEORGIA ST",
            "address_2": "SUITE #225",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905964",
            "telephone_number": "707-553-1971",
            "fax_number": "707-553-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "EVELYN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT30084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerica L Podrat, MD
• Ellen Kathleen Pohl, R.N.
• Kristen Poitra
• Veronica Dee O'Day Pokorny, RN
• Claire Lebah Polansky
• Tehauna Souix Ponce
• Angela McNeilly Poncelas, MPT
• Kathie Anne Pongrace, LCSW
• Jose Maximiliano Ponssa
• Juanito L. Pontejos, DO

• Marriage & Family Therapist in Vallejo, CA
• Providers in Vallejo, 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 8, 2011; 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.