Organization Active NPI

Ileihno Bopachemihn, Inc.

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1124735758
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
ILEIHNO BOPACHEMIHN, INC.
Practice address
4616 El Camino Avenue
Suite B
Sacramento, CA 95821
Phone
(619) 701-2546
NPI assigned
Nov 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tatiana Moore, LMFTNPI 1801171442
Title
Clinical Services Director
Phone
(619) 701-2546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

4616 El Camino Avenue
Suite B
Sacramento, CA 95821

Mailing address

4616 El Camino Avenue
Suite B
Sacramento, CA 95821
Phone (619) 701-2546

Other practice location 1

750 E Grand Ave Ste A
Escondido, CA 92025-4460
Phone (619) 701-2546

Other names 1

  • Tribal Oak Tree Foster Family Agency Doing business as

National Provider Directory

National Provider Directory

Locations

4616 El Camino Ave
Unit B
Sacramento, CA 95821
Phone (619) 701-2546

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1124735758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 EL CAMINO AVENUE",
            "address_2": "SUITE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95821",
            "telephone_number": "619-701-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 EL CAMINO AVENUE",
            "address_2": "SUITE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95821",
            "telephone_number": "619-701-2546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Grand Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920254460",
            "country_code": "US",
            "telephone_number": "619-701-2546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ILEIHNO BOPACHEMIHN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "CLINICAL SERVICES DIRECTOR",
        "authorized_official_telephone_number": "619-701-2546",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tribal Oak Tree Foster Family Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.