Provider Demographics
NPI:1891393799
Name:OREKOYA, OMOYINKA
Entity Type:Individual
Prefix:MS
First Name:OMOYINKA
Middle Name:
Last Name:OREKOYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13931 JOCKEY LN
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-7563
Mailing Address - Country:US
Mailing Address - Phone:626-502-3577
Mailing Address - Fax:
Practice Address - Street 1:BARSTOW COUNSELING CENTER
Practice Address - Street 2:1841 E MAIN STREET
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311
Practice Address - Country:US
Practice Address - Phone:760-255-5700
Practice Address - Fax:760-256-5092
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW106330104100000X
CA172V00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172V00000XOther Service ProvidersCommunity Health Worker