DR. ADAM DAVID POLLACK PSY.D.
NPI 1689735854
Psychologist - Clinical in Stockton, CA

Q: What is Adam Pollack's NPI number?

The NPI number for Adam Pollack is 1689735854. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Q: What is Adam Pollack's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Adam Pollack was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 12, 2006PECOS Enrolled

1305 TOMMYDON ST, KAISER PERMANENTE, DEPT. OF MENTAL HEALTH, STOCKTON, CA 95210(209) 476-5510 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Adam David Pollack Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ADAM DAVID POLLACK PSY.D. (NPI 1689735854) is an individual clinical provider in Stockton, California, licensed in California (PSY 18422) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689735854

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. ADAM DAVID POLLACKCredential: PSY.D.

Location Address1305 TOMMYDON ST, KAISER PERMANENTE, DEPT. OF MENTAL HEALTHStockton, CA 95210-3364

Mailing Address1305 Tommydon St, Attn: Mental Health Dept.Stockton, CA 95210-3364 · (209) 476-5510

Phone(209) 476-5510

Sole ProprietorNo

Enumeration DateDecember 12, 2006

Last NPPES UpdateDecember 30, 2021

✔ NPI 1689735854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · PSY 18422

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1305 TOMMYDON ST, Stockton, CA 95210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Adam David Pollack Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Adam Pollack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

0.1 mi

Internal Medicine

7373 WEST LANE
Stockton, CA 95210

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$176.60 typical visit price

range $58.87 – $176.60

Typical copayment $44.15 (range $14.71 – $44.15)

Most-billed visit code 99205

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK ALLEN BOURASSA

Counselor (Professional)