Provider Demographics
NPI:1639448772
Name:O'CALLAGHAN, CHRIS S
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:S
Last Name:O'CALLAGHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5596
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-5596
Mailing Address - Country:US
Mailing Address - Phone:808-756-5860
Mailing Address - Fax:
Practice Address - Street 1:73-4411 KAKAHIAKA ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-7525
Practice Address - Country:US
Practice Address - Phone:808-756-5860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor