Individual provider Active NPI

Omoyinka Orekoya

  • Clinical Social Worker
  • Victorville, CA
National Provider Identifier
1891393799
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW106330 Issued in CA
Practice address
12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone
(760) 684-4146
Fax
(760) 684-8111
NPI assigned
Oct 13, 2020
Last updated
Aug 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X ASW106330 CA Primary
Community Health Worker 172V00000X CA

Addresses

Primary practice location

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753

Mailing address

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone (760) 684-4146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251001001775 CA Practitioner - Clinical Social Worker 8325544174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12640 Hesperia Rd
Suite D
Victorville, CA 92395-7753
Phone (760) 684-4143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW106330CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tobias Moeller-Bertram MD Corporation CurrentSince Aug 1, 2025 Accepting new patients
Tobias Moeller-Bertram MD Corporation CurrentSince Aug 1, 2025 Accepting new patients

Locations

44630 Monterey Ave
Ste 100
Palm Desert, CA 92260
Phone (760) 340-4290

36101 Bob Hope Dr
Ste A
Rancho Mirage, CA 92270
Phone (760) 321-1315

12640 Hesperia Rd
Ste D
Victorville, CA 92395
Phone (760) 684-4143

12830 Hesperia Rd
Ste Ad
Victorville, CA 92395
Phone (760) 684-8999

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1891393799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE D",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "760-684-4146",
            "fax_number": "760-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE D",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "760-684-4146",
            "fax_number": "760-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OREKOYA",
        "first_name": "OMOYINKA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW106330",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.