Marina Obolnikov, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A91716 Issued in CA

Practice address

802 Brewster Ave
Redwood City, CA 94063-1510

Phone

(650) 363-4111

Fax

(650) 364-6927

NPI assigned

May 21, 2007

Last updated

Dec 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Marina I Obolnikov Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Telecare Corporation

  dba Gateway To Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1720164882
  Medicare reassignment
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  NPD
• Hiawatha Harris, Corporation

  dba Pathways To Wellness Medication Clinic

  • Clinical Child & Adolescent Psychologist
  • Martinez, CA
  • NPI 1407063936
  NPD
• Hiawatha Harris, M.D., Inc.

  dba Pathways To Wellness Medication Clinic

  • Psychologist
  • Pleasanton, CA
  • NPI 1023151693
  NPD
• Hiawatha Harris, M.D., Inc.

  dba Pathways To Wellness, Medication Clinic

  • Mental Health Counselor
  • Oakland, CA
  • NPI 1942420724
  NPD
• San Mateo County

  dba Harbor

  • Community/Behavioral Health Agency
  • Belmont, CA
  • NPI 1013103381

  Psychiatry

  NPD
• Hiawatha Harris, M.D., Inc.

  • Counselor
  • Oakland, CA
  • NPI 1487074845
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607212800000",
    "number": "1174732713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 BREWSTER AVE",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631510",
            "telephone_number": "650-363-4111",
            "fax_number": "650-364-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 BREWSTER AVE",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631510",
            "telephone_number": "650-363-4111",
            "fax_number": "650-364-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBOLNIKOV",
        "first_name": "MARINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A91716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "OBOLNIKOV",
            "middle_name": "I",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Julie Marie O'Keefe
• Sophie O'Shaughnessy, F.N.P
• Maria O'Shea
• Benjamin John Ober-Reynolds, MD, PHD
• Vivian Obichere, CNA, HHA
• Crystal Tiffany Ochoa
• Michele Rae Ochoa, VNIVBWP
• Ziomara Ochoa
• Eui Suk Isaac Oh, RCP
• Jocelyn Tagle Ohalloran, MASSAGE THERAPIST

• Psychiatry Physician in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.