Basic Information
| Provider Information | |||||||||
| NPI: | 1891393799 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OREKOYA | ||||||||
| FirstName: | OMOYINKA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15095 AMARGOSA RD | ||||||||
| Address2: | |||||||||
| City: | VICTORVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923941879 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | BARSTOW COUNSELING CENTER | ||||||||
| Address2: | 1841 E MAIN STREET | ||||||||
| City: | BARSTOW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602555700 | ||||||||
| FaxNumber: | 7602565092 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2020 | ||||||||
| LastUpdateDate: | 07/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | CA | N | Other Service Providers | Community Health Worker | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.