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Organization
ILEIHNO BOPACHEMIHN, INC.
Active
Organization
ILEIHNO BOPACHEMIHN, INC.
Active
Other names
Tribal Oak Tree Foster Family Agency
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA MOORE LMFT (CLINICAL SERVICES DIRECTOR)
(619) 701-2546
Entity
Organization
Contact information
Practice address
4616 EL CAMINO AVENUE, SUITE B, SACRAMENTO, CA 95821
(619) 701-2546
Mailing address
4616 EL CAMINO AVENUE, SUITE B, SACRAMENTO, CA 95821
(619) 701-2546
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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