Doctor Name: | OLGA PETLINSKA |
NPI Number: | 1164785671 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA22311 |
Business Practice Address: | 1995 Zinfandel Dr Suite 201 Rancho Cordova, CA - 956702862 |
Business Phone Number: | 9168526001 |
Business Fax Number: | |
Mailing Address: | 1995 Zinfandel Dr, Ste. 201 RANCHO CORDOVA |
State: | CA |
Postal Code: | 956702862 |
Phone Number: | 9168526001 |
Fax Number: | 9168526007 |
NPI Enumeration Date: | 06/19/2012 |
NPI Last Update Date: | 04/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA22311 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |