Healthcare Provider Details

I. General information

NPI: 1922957455
Provider Name (Legal Business Name): LINCOLN WEST THERAPY CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 OLD COURTHOUSE SQ STE 310
SANTA ROSA CA
95404-4923
US

IV. Provider business mailing address

50 OLD COURTHOUSE SQ STE 310
SANTA ROSA CA
95404-4923
US

V. Phone/Fax

Practice location:
  • Phone: 323-425-3249
  • Fax:
Mailing address:
  • Phone: 323-425-3249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SYDNEY ABRAMSON
Title or Position: OWNER
Credential:
Phone: 561-990-6571