Active NPI
William Howard Polonsky, PHD
- Health Psychologist
- San Diego, CA
National Provider Identifier
1720414014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Psychologist
- License
- PSY13764
- Practice address
- 5405 Oberlin Dr
Suite 100
San Diego, CA 92121-1700 - Phone
- (760) 525-5256
- Fax
- (760) 942-5780
- NPI assigned
- Sep 19, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Psychologist | 103TH0004X | PSY13764 | CA | Primary |
Addresses
Primary practice location
5405 Oberlin Dr
Suite 100
San Diego, CA 92121-1700
Mailing address
PO Box 2148
Del Mar, CA 92014-1448
Phone (760) 525-5256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY13764 | CA | MD | Health Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1720414014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2148",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920141448",
"telephone_number": "760-525-5256",
"fax_number": "760-942-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 OBERLIN DR",
"address_2": "SUITE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211700",
"telephone_number": "760-525-5256",
"fax_number": "760-942-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLONSKY",
"first_name": "WILLIAM",
"middle_name": "HOWARD",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-19",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "CA",
"license": "PSY13764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.