Provider Demographics
NPI:1154778371
Name:POLADIAN, ERIKA LYNNE (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:LYNNE
Last Name:POLADIAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 E COLORADO BLVD STE 810
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2001
Mailing Address - Country:US
Mailing Address - Phone:626-765-4045
Mailing Address - Fax:
Practice Address - Street 1:595 E COLORADO BLVD STE 810
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2001
Practice Address - Country:US
Practice Address - Phone:626-765-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100831106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194214239OtherMIND STUDY CENTER