Polina Eidelman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25550 Issued in CA

Practice address

5440 Morehouse Dr Ste 3800
San Diego, CA 92121-6703

Phone

(858) 926-7333

NPI assigned

Feb 27, 2013

Last updated

Mar 21, 2020By 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

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Polina Eidelman, PH.D. Psychology Corporation

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1710851464
  NPD

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584748800000",
    "number": "1972843977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 MOREHOUSE DR STE 3800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921216703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 MOREHOUSE DR STE 3800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921216703",
            "telephone_number": "858-926-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDELMAN",
        "first_name": "POLINA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2020-03-21",
        "certification_date": "2020-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Zhang Eichenfield, M.D., PH.D.
• Lawrence F Eichenfield, M.D.
• Nicole Danielle Eichinger, RD
• Emilie Ugland Eide
• Olivia Eide
• Joncannon Eiden
• Sarah C Eifert, ANP
• Brandi Eijsermans
• Joshua Eikamp, RN
• Veronica Turla Eikamp

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.