Provider Demographics
NPI:1316008584
Name:OBOLENSKY, ELIZABETH R (MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:OBOLENSKY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 W MACARTHUR BLVD
Mailing Address - Street 2:KAISER PERMANENTE OAKLAND MEDICAL CENTER
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5641
Mailing Address - Country:US
Mailing Address - Phone:510-752-6298
Mailing Address - Fax:510-752-6754
Practice Address - Street 1:275 W MACARTHUR BLVD
Practice Address - Street 2:KAISER PERMANENTE OAKLAND MEDICAL CENTER
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5641
Practice Address - Country:US
Practice Address - Phone:510-752-6298
Practice Address - Fax:510-752-6754
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS