Provider Demographics
NPI:1366764300
Name:O'CON, MARCELA FABIOLA
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:FABIOLA
Last Name:O'CON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARCELA
Other - Middle Name:FABIOLA
Other - Last Name:ROLANDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4795 LOGANA PLZ
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3510
Mailing Address - Country:US
Mailing Address - Phone:714-336-4894
Mailing Address - Fax:
Practice Address - Street 1:4795 LOGANA PLZ
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886
Practice Address - Country:US
Practice Address - Phone:714-336-4894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA534913163W00000X
CANA3964367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse