Provider Demographics
NPI:1174843924
Name:POLSKY, KATIE SARAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:SARAH
Last Name:POLSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2862 ARDEN WAY
Mailing Address - Street 2:STE 215A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-1389
Mailing Address - Country:US
Mailing Address - Phone:916-284-1416
Mailing Address - Fax:
Practice Address - Street 1:2862 ARDEN WAY
Practice Address - Street 2:STE 215A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-1389
Practice Address - Country:US
Practice Address - Phone:916-284-1416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23342103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical