Organization
LINCOLN
Active
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
3750 BROWN AVE, OAKLAND, CA 94619-1406
(510) 273-4700
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
07/24/2013
Last updated
11/12/2024
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