Provider Demographics
NPI:1659497899
Name:POLA, EILEEN D (MA MFT)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:D
Last Name:POLA
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:MS
Other - First Name:EILEEN
Other - Middle Name:D
Other - Last Name:FLASHBERG POLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16663 MORRISON STREET
Mailing Address - Street 2:PRIVATE OFFICE IN HOME
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-995-4013
Mailing Address - Fax:818-995-4013
Practice Address - Street 1:16663 MORRISON STREET
Practice Address - Street 2:PRIVATE OFFICE IN HOME
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-995-4013
Practice Address - Fax:818-995-4013
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
M12607106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist