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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Street Address |
7200 BANCROFT AVE SUITE 125A |
City | OAKLAND |
State | CA |
Zip Code | 94605-2403 |
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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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 |
Find all providers in zip 94605 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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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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.