Organization Active NPI

Lincoln Villa Corp

  • Assisted Living Facility
  • Fremont, CA
National Provider Identifier
1639979719
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
LINCOLN VILLA CORP
Doing business as
Lincoln Villa Corp
Practice address
41040 Lincoln St
Fremont, CA 94538-4316
Phone
(510) 656-4373
NPI assigned
Mar 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Wendy Wong
Title
Corporate Representative
Phone
(510) 390-8078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

41040 Lincoln St
Fremont, CA 94538-4316

Mailing address

24647 Mohr Dr
Hayward, CA 94545-2309
Phone (510) 390-8078

Other names 1

  • Lincoln Villa Corp Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1639979719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24647 MOHR DR",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452309",
            "telephone_number": "510-390-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41040 LINCOLN ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384316",
            "telephone_number": "510-656-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN VILLA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CORPORATE REPRESENTATIVE",
        "authorized_official_telephone_number": "510-390-8078"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Villa Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.