Full Name | Lincoln |
---|---|
Speciality | Community/behavioral Health |
Location | 4720 Dunkirk Ave, Oakland, California |
Authorized Official Name and Position | Allison Staulcup Becwar (CHIEF PROGRAM OFFICER) |
Authorized Official Contact | 5102734700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lincoln 1266 14th St Oakland CA 94607-2205 Ph: (510) 531-3111 | Lincoln 4720 Dunkirk Ave Oakland CA 94605-5607 Ph: (510) 636-4653 |
NPI Number | 1023569993 |
---|---|
Provider Enumeration Date | 10/17/2016 |
Last Update Date | 10/17/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023569993 | NPI | - | NPPES |
0000054BM | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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