Portia Polner, PH D LIC PSYCHOLOGIS

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY11003 Issued in CA

Practice address

2255 Morello Avenue
Ste 119
Pleasant Hill, CA 94523

Phone

(925) 798-5323

Fax

(510) 339-8183

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Encore Clinical Consultation

  • Clinical Social Worker
  • Pleasant Hill, CA
  • NPI 1235773177
  NPD (past)
• Good Roots Psychotherapy

  • Mental Health Counselor
  • Pleasant Hill, CA
  • NPI 1235086976
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346351608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 MORELLO AVENUE",
            "address_2": "STE 119",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "94523",
            "telephone_number": "925-798-5323",
            "fax_number": "510-339-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 MORELLO AVENUE",
            "address_2": "STE 119",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "94523",
            "telephone_number": "925-798-5323",
            "fax_number": "510-339-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLNER",
        "first_name": "PORTIA",
        "name_prefix": "Dr.",
        "credential": "PH D LIC PSYCHOLOGIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY11003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pleasant Hill Villa Home Care 3
• Pleasant Hill Wellness Center, a Medical Corporation
• Pleasant Hillidence Opco, LLC
• David Stuart Pollack, PH. D.
• Cassidie Pollard
• Michelle Pongol
• Andres Armando Portillo, DC
• Posy Inc.
• Scott Powell
• Jillene Rlayne Prater

• Psychologist in Pleasant Hill, CA
• Providers in Pleasant Hill, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.