# BLUE OAK COUNSELING SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073124285
- **Authorized official:** MRS. TINA TANGTHEINKUL AVILA MA, LMFT (CEO)
- **Authorized official phone:** (909) 366-4712

## Contact information

- **Practice address:** 3200 E GUASTI RD STE 100, ONTARIO, CA 91761-8661
- **Practice address phone:** (909) 306-8686
- **Mailing address:** 3200 E GUASTI RD STE 100, ONTARIO, CA 91761-8661
- **Mailing address phone:** (909) 306-8686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2020
- **Last updated:** 12/13/2024