Organization
BLUE OAK COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA TANGTHEINKUL AVILA LMFT (CEO)
(909) 306-8686
Entity
Organization
Contact information
Practice address
3200 GUASTI RD #100, ONTARIO, CA 91761
(909) 306-8686
(909) 510-8260
Mailing address
3200 GUASTI RD #100, ONTARIO, CA 91761
(909) 306-8686
(909) 510-8260
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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