Physician Compare National (NPI:1346351608)

HEALTHCARE PROVIDER: PORTIA POLNER PH D LIC PSYCHOLOGIS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1346351608
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103092200
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200609003176
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POLNER
	Individual professional last name
Provider First Name	PORTIA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2255 MORELLO AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 119
	Group Practice or individual's line 2 address
City	PLEASANT HILL
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945231855
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9257985323
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y