NPIMap

Organization Active NPI

Lifelong Medical Care

  • Clinical Social Worker
  • Richmond, CA
National Provider Identifier
1225418544
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW11778 Issued in CA
Legal business name
LIFELONG MEDICAL CARE
Practice address
1030 Nevin Ave
Richmond, CA 94801-3122
Phone
(510) 215-5001
NPI assigned
Jun 2, 2015
Last updated
Jun 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rick Clark, CONSULTANT
Title
Consultant
Phone
(510) 981-3203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW11778 CA Primary

Addresses

Primary practice location

1030 Nevin Ave
Richmond, CA 94801-3122

Mailing address

2344 6TH St
Berkeley, CA 94710-2412
Phone (510) 981-3203

National Provider Directory

National Provider Directory
Tax ID family
Lifelong Medical Center44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1225418544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 6TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102412",
            "telephone_number": "510-981-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 NEVIN AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948013122",
            "telephone_number": "510-215-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "510-981-3203",
        "authorized_official_credential": "CONSULTANT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW11778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.