Provider Demographics
NPI:1164785671
Name:PETLINSKA, OLGA (PA-C)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:PETLINSKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 ZINFANDEL DR
Mailing Address - Street 2:STE. 201
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2862
Mailing Address - Country:US
Mailing Address - Phone:916-852-6001
Mailing Address - Fax:916-852-6007
Practice Address - Street 1:1995 ZINFANDEL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2862
Practice Address - Country:US
Practice Address - Phone:916-852-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22311363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical