Healthcare Provider Details

I. General information

NPI: 1588597330
Provider Name (Legal Business Name): IDEAL LANELL FRANKLIN CWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 HARRISON ST
OAKLAND CA
94612-3813
US

IV. Provider business mailing address

2629 HARRISON ST
OAKLAND CA
94612-3813
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-2213
  • Fax:
Mailing address:
  • Phone: 510-879-2213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: