Provider Demographics
NPI:1033343686
Name:O'CANA, TONY I (BA SOCIOLOGY)
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:
Last Name:O'CANA
Suffix:I
Gender:M
Credentials:BA SOCIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 E BIRCH HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-5067
Mailing Address - Country:US
Mailing Address - Phone:719-580-5158
Mailing Address - Fax:
Practice Address - Street 1:1302 CHINOOK
Practice Address - Street 2:SPANISH PEAKS MENTAL HEALTH CENTER
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003
Practice Address - Country:US
Practice Address - Phone:719-545-2746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker