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DR. ANDREA POLK PH D
NPI 1790899581
Psychologist - Clinical in Pacifica, CA

Active since August 18, 2006Opted out of Medicare · through Oct 1, 2027
80 EUREKA SQUARE, SUITE 124, PACIFICA, CA 94044(650) 359-0711(650) 738-1246 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Andrea Polk Ph D NPPES

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

DR. ANDREA POLK PH D (NPI 1790899581) is an individual clinical provider in Pacifica, California, licensed in California (PSY11637) and active in the NPI registry since August 2006. She has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1790899581
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. ANDREA POLKCredential: PH D
Location Address80 EUREKA SQUARE, SUITE 124Pacifica, CA 94044
Mailing Address80 Eureka Square, Ste 124Pacifica, CA 94044
Phone(650) 359-0711
Fax(650) 738-1246
Sole ProprietorNo
Enumeration DateAugust 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1790899581 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 · PSY11637
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.
80 EUREKA SQUARE, Pacifica, CA 94044
Open in Google Maps ↗

Other Identifiers 1

Other164390Value Options

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Andrea Polk Ph D has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2017 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2017
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94044 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
$202.35 typical visit price
range $69.00 – $202.35
Typical copayment $50.58 (range $17.25 – $50.58)
Most-billed visit code 99205
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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 2

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

WEST BAY SLEEP LAB
Clinical Medical Laboratory
80 EUREKA SQUARE, SUITE #218
PACIFICA, CA 94044
San Mateo County (650) 733-7012
JENNIFER LYNNE GILMAN MFT
Marriage & Family Therapist
80 EUREKA SQUARE, SUITE 147
PACIFICA, CA 94044
San Mateo County (650) 557-0304

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrea Polk's NPI number?

The NPI number for Andrea Polk is 1790899581. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is Andrea Polk located?

Andrea Polk practices at 80 Eureka Square Suite 124, Pacifica, CA 94044. The listed phone number is (650) 359-0711.

What is Andrea Polk's specialty?

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

Is Andrea Polk enrolled in Medicare?

No. Andrea Polk has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Andrea Polk was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.