Healthcare Provider Details

I. General information

NPI: 1851643902
Provider Name (Legal Business Name): MELISSA QUINN POLLOCK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA QUINN MEYER

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14433 RANGE PARK ROAD
POWAY CA
92064-3112
US

IV. Provider business mailing address

14433 RANGE PARK ROAD
POWAY CA
92064-3112
US

V. Phone/Fax

Practice location:
  • Phone: 312-217-6885
  • Fax:
Mailing address:
  • Phone: 312-217-6885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW76707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: