LIFELONG MEDICAL CARE - EASTMONT


Address: 7200 Bancroft Ave, Suite 125a, Oakland, CA 94605-2403
Phone: 5104308740

LIFELONG MEDICAL CARE - EASTMONT (NPI# 1831443563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1831443563
Entity Type Organization
Organization Name LIFELONG MEDICAL CARE - EASTMONT
Practice Address 7200 Bancroft Ave
Suite 125a
Oakland
CA 94605-2403
Mailing Address Po Box 11247
Berkeley
CA 94712-2247
Practice Telephone 5104308740
Mailing Telephone 5109814122
Enumeration Date 2012-11-02
Last Update Date 2012-11-02
Authorized Official Name MR. RICK CLARK (CHIEF FINANCIAL OFFICER)
Authorized Official Telephone 5109814122
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Office Location

Street Address 7200 BANCROFT AVE
SUITE 125A
City OAKLAND
State CA
Zip Code 94605-2403

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801816244 Alexander Enacio Jackson Social Worker 7200 Bancroft Ave, Suite 125-d, Alameda County Bhcs, Oakland, CA 94605-2403 2006-07-20
1538777545 Cynthia Solorza Counselor 7200 Bancroft Ave, Oakland, CA 94605-2403 2020-07-15
1154963338 Grace Hong Counselor 7200 Bancroft Ave, Oakland, CA 94605-2403 2019-10-09
1114580636 Sarah G Chaaito Pharmacist 7200 Bancroft Ave, Oakland, CA 94605-2403 2019-04-19
1558848796 Kristina Marie Nestlerode Counselor 7200 Bancroft Ave, Oakland, CA 94605 2018-07-20
1558875864 Lizeth Corina Torres Chavez Specialist 7200 Bancroft Ave, Oakland, CA 94605-2403 2017-11-22
1932637915 Binh T Au Social Worker 7200 Bancroft Ave, Oakland, CA 94605-2403 2017-06-02
1922536374 Kelli Clark Social Worker 7200 Bancroft Ave, Oakland, CA 94605-2403 2017-05-30
1558808741 Karina Gabriela Paredes Specialist 7200 Bancroft Ave, Ste 267, Oakland, CA 94605-2403 2017-01-25
1306383088 Kally Price Registered Nurse 7200 Bancroft Ave, # 204, Oakland, CA 94605-2403 2017-01-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1275181190 Sarah Primack Counselor Castlemont High School, 8601 Macarthur Blvd, Oakland, CA 94605 2019-09-04
1285296475 Veronica Aguila Behavior Technician 2949 Parker Ave, Oakland, CA 94605 2019-07-08
1508321886 Terra Brown Brown Counselor One Eastmont Mall Town Center, 7200 Bancroft Avenue Building B. Suite 133, Oakland, CA 94605 2019-01-31
1619447455 Elizabeth Niarhos Counselor 10850 Macarthur Blvd., Oakland, CA 94605 2018-12-04
1467930966 Claudia Sanchez Student in an Organized Health Care Education/Training Program 7200 Bancroft Avenue, Suite 125d, Oakland, CA 94605 2018-08-06
1447768866 The Alliance for Community Wellness Community/Behavioral Health 2369 84th Ave., Oakland, CA 94605 2018-01-19
1497204010 Nekeisha Maxie Specialist 7200 Bancroft Ave. Bldg. B Suite 133, Oakland, CA 94605 2016-09-23
1073997110 Sandra Lenoski Social Worker 7200 Bancroft Avenue, Building B, Suite 133, Oakland, CA 94605 2015-07-18
1366831414 Wing Kit Leung Physical Therapy Assistant 2445 64th Ave, Oakland, CA 94605 2015-01-13
1558647735 Jessica Welsh Counselor 8759 Mountain Blvd. Bldg. 69, Oakland, CA 94605 2011-11-01
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821501792 Asian Health Services Clinic/Center 190 11th St, Oakland, CA 94607-4878 2017-11-14
1407109986 County of Alameda Health Care Services Agency Clinic/Center 384 14th St, Oakland, CA 94612-3211 2012-10-20
1073827242 Asian Health Services Clinic/Center 817 Harrison Street, Oakland, CA 94607-4422 2010-07-30
1104959089 Alameda Health System Clinic/Center 6955 Foothill Blvd Suite 200, Oakland, CA 94605-2409 2007-03-13
1679522627 The West Oakland Health Council Clinic/Center 700 Adeline St, Oakland, CA 94607-2608 2006-05-08
1003340738 Roosevelt School-based Behavioral Health Clinic/Center 1926 E 19th St, Oakland, CA 94606-4126 2017-04-19
1386096691 Asian Health Services Clinic/Center 310 8th St Ste 210, Oakland, CA 94607 2016-07-11
1770902314 La Clinica De La Raza, Inc. Clinic/Center 1450 Fruitvale Ave, 3rd Floor, Oakland, CA 94601-2313 2014-04-10
1467718148 Asian Health Services Clinic/Center 275 14th St, Oakland, CA 94612-4070 2012-04-06
1750656427 Asian Health Services - Behavior Services Clinic/Center 818 Webster St, Oakland, CA 94607-4220 2012-03-14
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Competitor

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City OAKLAND
Zip Code 94605

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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