Provider Demographics
NPI:1699085209
Name:OBRIST, KANDI
Entity type:Individual
Prefix:
First Name:KANDI
Middle Name:
Last Name:OBRIST
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 1:3617 S. PACIFIC HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501
Mailing Address - Country:US
Mailing Address - Phone:541-535-6239
Mailing Address - Fax:541-535-4377
Practice Address - Street 1:145 S HOLLY ST STE B
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-3101
Practice Address - Country:US
Practice Address - Phone:541-500-8655
Practice Address - Fax:541-535-4377
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health