Provider Demographics
NPI:1962525352
Name:KOLODJI, YELENA MARIE (RN, CNM)
Entity type:Individual
Prefix:MS
First Name:YELENA
Middle Name:MARIE
Last Name:KOLODJI
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20941 NEZ PERCE TRL
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-8882
Mailing Address - Country:US
Mailing Address - Phone:408-353-1118
Mailing Address - Fax:408-353-1119
Practice Address - Street 1:20941 NEZ PERCE TRL
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95033-8882
Practice Address - Country:US
Practice Address - Phone:408-353-1118
Practice Address - Fax:408-353-1119
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA704176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife