Provider Demographics
NPI:1316521826
Name:POLLAK, YOCHEVED (MS)
Entity type:Individual
Prefix:
First Name:YOCHEVED
Middle Name:
Last Name:POLLAK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:YOCHEVED
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:209 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3414
Mailing Address - Country:US
Mailing Address - Phone:347-585-6690
Mailing Address - Fax:
Practice Address - Street 1:80 HILLSIDE BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3798
Practice Address - Country:US
Practice Address - Phone:732-534-7325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-21-49585103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst