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General NPI Number Information
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NPI Number | 1285003418
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Entity Type | Organization
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Legal Business Name | JILL POLLOCK MARRIAGE AND FAMILY THERAPY
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 18 E STATE ST STE 204-2
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City | REDLANDS
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State | CA
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Zip | 92373-4730
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Country | US
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Telephone | 909-289-1342
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Fax |
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Provider Business Mailing Address
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Address Line | 18 E STATE ST STE 204-2
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City | REDLANDS
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State | CA
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Zip | 92373-4730
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Country | US
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Telephone | 909-289-1342
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | MS. JILL POLLOCK
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Credential | LMFT
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Telephone | 909-289-1342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LMFT47024
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License Number State | CA
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