Provider Demographics
NPI:1285402313
Name:POLLOCK, ROBIN LIN (MS)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LIN
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S HALE AVE SPC 16
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-2175
Mailing Address - Country:US
Mailing Address - Phone:619-307-1412
Mailing Address - Fax:
Practice Address - Street 1:1001 S HALE AVE SPC 16
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-2175
Practice Address - Country:US
Practice Address - Phone:619-307-1412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18418101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool