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General NPI Number Information
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NPI Number | 1700367166
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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 | 08/23/2018
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 4721 VISTA GRANDE DR
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City | ANTIOCH
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State | CA
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Zip | 94531-8619
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Country | US
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Telephone | 925-779-7475
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Fax | 925-779-7476
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Provider Business Mailing Address
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Address Line | 150 LINDEN ST
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City | OAKLAND
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State | CA
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Zip | 94607-2538
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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 EXECUTIVE 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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