Healthcare Provider Details

I. General information

NPI: 1518529825
Provider Name (Legal Business Name): LINCOLN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 10TH ST
OAKLAND CA
94607-3106
US

IV. Provider business mailing address

1266 14TH ST
OAKLAND CA
94607-2247
US

V. Phone/Fax

Practice location:
  • Phone: 510-874-3381
  • Fax: 510-874-3388
Mailing address:
  • Phone: 510-273-4700
  • 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. NANCY OAKLEY
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 510-273-4700