Provider Demographics
NPI:1881244218
Name:OBLITAS, GILKA (MA)
Entity type:Individual
Prefix:
First Name:GILKA
Middle Name:
Last Name:OBLITAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:GILKA
Other - Last Name:OBLITAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:2503 W 4TH ST APT 12
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1842
Mailing Address - Country:US
Mailing Address - Phone:562-225-6400
Mailing Address - Fax:
Practice Address - Street 1:3752 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-6667
Practice Address - Country:US
Practice Address - Phone:562-606-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst