Provider Demographics
NPI:1952096067
Name:POLLARD, AGNIESZKA (PHD)
Entity type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:POLLARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:AJ
Other - Middle Name:
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4237 CONQUISTA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-3203
Mailing Address - Country:US
Mailing Address - Phone:562-508-2204
Mailing Address - Fax:
Practice Address - Street 1:3734 6TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4317
Practice Address - Country:US
Practice Address - Phone:619-354-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36314103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical