Provider Demographics
NPI:1518194927
Name:POLLON, JOSEPH LEE (MFT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEE
Last Name:POLLON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 E BRANCH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-2701
Mailing Address - Country:US
Mailing Address - Phone:805-489-3733
Mailing Address - Fax:
Practice Address - Street 1:129 E BRANCH ST
Practice Address - Street 2:SUITE A
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-2701
Practice Address - Country:US
Practice Address - Phone:805-489-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44654106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist