MEDICARE: DR. ADAM EVAN POLLOCK PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY17356	CA

General Provider Information

NPI Number	:	1003138298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM EVAN POLLOCK PSY.D.

Provider Business Mailing Address
First Line	:	3601 S HARBOR BLVD
Second Line	:	100
City	:	SANTA ANA
State	:	CA
Zip	:	92704-7909
Country	:	US
Telephone Number	:	714-428-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 S HARBOR BLVD
Second Line	:	100
City	:	SANTA ANA
State	:	CA
Zip	:	92704-7909
Country	:	US
Telephone Number	:	714-428-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2010
Last Update Date	:	11/30/2021

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