Healthcare Provider Details

I. General information

NPI: 1346510047
Provider Name (Legal Business Name): LINCOLN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BOSTON AVE
OAKLAND CA
94602-2899
US

IV. Provider business mailing address

150 LINDEN ST
OAKLAND CA
94607-2538
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-1170
  • Fax: 510-879-1179
Mailing address:
  • Phone: 510-852-0130
  • Fax: 510-530-8083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ALLISON BECWAR
Title or Position: SENIOR DIRECTOR
Credential: LCSW
Phone: 510-867-0944