Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | CA 74770 | CA |
NPI | 1003012600 |
---|---|
Provider Name | Adrienne Resnick Polster |
First Address | San Francisco, CA 94121-3831 |
Second Address | San Francisco, CA 94118-3213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 13/09/2018 |