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General NPI Number Information
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NPI Number | 1497136931
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Entity Type | Organization
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Legal Business Name | LINCOLN
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Dates
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Enumeration Date | 06/10/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 1700 MARKET ST
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City | OAKLAND
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State | CA
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Zip | 94607-3330
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Country | US
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Telephone | 510-874-7774
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Fax | 510-874-7742
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Provider Business Mailing Address
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Address Line | 1266 14TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-2205
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Country | US
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Telephone | 510-273-4700
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Fax | 510-530-8083
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Authorized Official
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Title or Position | CHIEF PROGRAM OFFICER
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Name | MS. ALLISON STAULCUP BECWAR
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Credential | LCSW
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Telephone | 510-273-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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