Provider Demographics
NPI:1245705235
Name:CALOCA, ENRIQUE (PMHNP)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:CALOCA
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 1:2301 BLAKE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2102
Mailing Address - Country:US
Mailing Address - Phone:720-713-0970
Mailing Address - Fax:
Practice Address - Street 1:2301 BLAKE ST STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2102
Practice Address - Country:US
Practice Address - Phone:720-713-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994176363LP0808X
MTMED-APRN-LIC-158319363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0994176OtherLICENSE
CORN.1657643OtherLICENSE
CORXN.0103542OtherLICENSE