Organization
LINCOLN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALLISON BECWAR LCSW (SENIOR DIRECTOR)
(510) 867-0944
Entity
Organization
Contact information
Practice address
5263 BROADWAY TER, OAKLAND, CA 94618-1418
(510) 654-7116
(510) 654-7157
Mailing address
1266 14TH ST, OAKLAND, CA 94607-2205
(510) 273-4700
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0183
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
08/17/2011
Last updated
12/07/2015
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