Organization
LINCOLN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALLISON STAULCUP BECWAR LCSW (CHIEF PROGRAM OFFICER)
(510) 273-4700
Entity
Organization
Contact information
Practice address
750 INTERNATIONAL BLVD, OAKLAND, CA 94606-2902
(510) 670-7619
(510) 670-3752
Mailing address
1266 14TH ST, OAKLAND, CA 94607-2205
(510) 531-3111
(510) 530-8083
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000054BM
—
CA
Enumeration date
10/14/2016
Last updated
10/14/2016
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