Provider Demographics
NPI:1518632710
Name:VENEGAS, O'CEANNA
Entity Type:Individual
Prefix:
First Name:O'CEANNA
Middle Name:
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 KAPIOLANI BLVD APT 602
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4863
Mailing Address - Country:US
Mailing Address - Phone:720-343-9010
Mailing Address - Fax:
Practice Address - Street 1:2751 KAPIOLANI BLVD APT 602
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-4863
Practice Address - Country:US
Practice Address - Phone:720-343-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician