Provider Demographics
NPI:1053892356
Name:LINCOLN
Entity type:Organization
Organization Name:LINCOLN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:STAULCUP BECWAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-273-4700
Mailing Address - Street 1:150 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-2538
Mailing Address - Country:US
Mailing Address - Phone:510-273-4700
Mailing Address - Fax:510-530-8083
Practice Address - Street 1:2801 ROOSEVELT LN
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-5038
Practice Address - Country:US
Practice Address - Phone:925-779-7495
Practice Address - Fax:925-779-7496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health