Organization
LINCOLN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON STAULCUP BECWAR LCSW (DIRECTOR OF SCHOOL-BASED SERVICES)
(510) 867-0944
Entity
Organization
Contact information
Practice address
581 61ST ST, OAKLAND, CA 94609-1248
(510) 531-3111
Mailing address
150 LINDEN ST, OAKLAND, CA 94607-2538
(510) 852-0130
(510) 530-8083
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000054BM
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
03/24/2010
Last updated
11/12/2024
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