Active NPI
Lincoln Villa Corp
- Assisted Living Facility
- Fremont, CA
National Provider Identifier
1639979719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryNPI 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.