Healthcare Provider Details

I. General information

NPI: 1336080779
Provider Name (Legal Business Name): THE FOUNDATION FOR SUSTAINING THE GOOD LIFE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 LIVINGSTON ST STE 214
OAKLAND CA
94606-5216
US

IV. Provider business mailing address

2220 LIVINGSTON ST STE 214
OAKLAND CA
94606-5216
US

V. Phone/Fax

Practice location:
  • Phone: 510-255-0232
  • Fax:
Mailing address:
  • Phone: 510-255-0232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: VIVIAN E ELGARICO
Title or Position: TREASURER
Credential:
Phone: 650-483-4287