Provider Demographics
NPI:1245749738
Name:OCAMPO, ALLAN ALDRICH JAMORA (PMHNP)
Entity Type:Individual
Prefix:
First Name:ALLAN ALDRICH
Middle Name:JAMORA
Last Name:OCAMPO
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2239
Mailing Address - Country:US
Mailing Address - Phone:716-363-6050
Mailing Address - Fax:833-974-1992
Practice Address - Street 1:75 E 3RD ST
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2239
Practice Address - Country:US
Practice Address - Phone:716-363-6050
Practice Address - Fax:833-974-1992
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017033627363L00000X
NYF403292-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420048740Medicaid
MO1245749738Medicaid