Provider Demographics
NPI:1295873610
Name:OBERSTEIN, ADRIENNE SUSANNE (MS)
Entity type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:SUSANNE
Last Name:OBERSTEIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3542
Mailing Address - Country:US
Mailing Address - Phone:510-336-3654
Mailing Address - Fax:
Practice Address - Street 1:39217 LIBERTY ST
Practice Address - Street 2:SUITE B-10
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1501
Practice Address - Country:US
Practice Address - Phone:510-791-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35602106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist