NPIMap

Organization Active NPI

Lifelong Medical Care

  • Community/Behavioral Health Agency
  • Oakland, CA
National Provider Identifier
1457761025
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
FHC70474G Issued in CA
Legal business name
LIFELONG MEDICAL CARE
Practice address
1415 Harrison St
201
Oakland, CA 94612-3922
Phone
(510) 981-4136
NPI assigned
May 5, 2014
Last updated
May 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Brenda Goldstein
Title
Psychosocial Services Director
Phone
(510) 981-4136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X FHC70474G CA Primary

Addresses

Primary practice location

1415 Harrison St
201
Oakland, CA 94612-3922

Mailing address

1415 Harrison St
201
Oakland, CA 94612-3922

Other identifiers 1

IdentifierTypeStateIssuer
FHC70474GMedicaidCA

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 2

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": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1457761025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HARRISON ST",
            "address_2": "201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 HARRISON ST",
            "address_2": "201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123922",
            "telephone_number": "510-981-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PSYCHOSOCIAL SERVICES DIRECTOR",
        "authorized_official_telephone_number": "510-981-4136"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "FHC70474G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70474G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.