Basic Information
| Provider Information | |||||||||
| NPI: | 1003012600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POLSTER | ||||||||
| FirstName: | ADRIENNE | ||||||||
| MiddleName: | RESNICK | ||||||||
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| Credential: | MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 691 20TH AVE | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941213831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204375835 | ||||||||
| FaxNumber: | 4157424979 | ||||||||
| Practice Location | |||||||||
| Address1: | 3516 GEARY BLVD | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941183213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4158515233 | ||||||||
| FaxNumber: | 4157424979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CA 74770 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.