# ILEIHNO BOPACHEMIHN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tribal Oak Tree Foster Family Agency
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124735758
- **Authorized official:** TATIANA MOORE LMFT (CLINICAL SERVICES DIRECTOR)
- **Authorized official phone:** (619) 701-2546

## Contact information

- **Practice address:** 4616 EL CAMINO AVENUE, SUITE B, SACRAMENTO, CA 95821
- **Practice address phone:** (619) 701-2546
- **Mailing address:** 4616 EL CAMINO AVENUE, SUITE B, SACRAMENTO, CA 95821
- **Mailing address phone:** (619) 701-2546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 11/02/2022
- **Last updated:** 11/02/2022