Healthcare Provider Details

I. General information

NPI: 1750229589
Provider Name (Legal Business Name): CHANA POLLACK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHANA EICHENBLATT RN

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5124 COLDWATER CANYON AVE APT 209
SHERMAN OAKS CA
91423-1686
US

IV. Provider business mailing address

5124 COLDWATER CANYON AVE APT 209
SHERMAN OAKS CA
91423-1686
US

V. Phone/Fax

Practice location:
  • Phone: 818-462-1454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95041632
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236667
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95212007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: