Provider Demographics
NPI:1952679151
Name:POLANSKY, CLAIRE LEBAH
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:LEBAH
Last Name:POLANSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21455 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2165
Mailing Address - Country:US
Mailing Address - Phone:510-871-7839
Mailing Address - Fax:
Practice Address - Street 1:4350 PALO VERDE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6332
Practice Address - Country:US
Practice Address - Phone:925-252-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146245106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist