Provider Demographics
NPI:1851005359
Name:POLANCO, ANALORENCE (ACSW 76768)
Entity Type:Individual
Prefix:
First Name:ANALORENCE
Middle Name:
Last Name:POLANCO
Suffix:
Gender:F
Credentials:ACSW 76768
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90707-0697
Mailing Address - Country:US
Mailing Address - Phone:562-925-3700
Mailing Address - Fax:
Practice Address - Street 1:17814 WOODRUFF AVE STE 3
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-7000
Practice Address - Country:US
Practice Address - Phone:562-925-3700
Practice Address - Fax:562-925-3705
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA767681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical