LIFELONG MEDICAL CARE (NPI# 1376931295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376931295 |
| Entity Type | Organization |
| Organization Name | LIFELONG MEDICAL CARE |
| Other Organization Name | LIFELONG TRUST HEALTH CENTER |
| Practice Address |
386 14th St Oakland CA 94612-3211 |
| Mailing Address |
Po Box 11247 Berkeley CA 94712-2247 |
| Practice Telephone | 5109814100 |
| Mailing Telephone | 5109814122 |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2016-10-14 |
| Authorized Official Name | MR. MARTIN LYNCH (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5109814123 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFELONG MEDICAL CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| LifeLong TRUST Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003289463 | Lifelong Medical Care | Family Medicine | 2 California St, Rodeo, CA 94572-1311 | 2015-11-06 |
| 1871919233 | Lifelong Medical Care | Case Management | 1415 Harrison St, Oakland, CA 94612-3922 | 2014-03-10 |
| 1598181950 | Lifelong Medical Care | Case Management | 1424 Jefferson St, Oakland, CA 94612-1972 | 2014-03-10 |
| 1871918524 | Lifelong Medical Care | Case Management | 3501 San Pablo Ave, Oakland, CA 94608-4255 | 2014-03-04 |
| 1154327138 | Lifelong Medical Care | Family Medicine | 10700 Macarthur Blvd, Ste 14b, Oakland, CA 94605-5260 | 2005-06-23 |
| 1013913300 | Lifelong Medical Care | Dentist | 1860 Alcatraz Ave, Berkeley, CA 94703-2715 | 2005-06-22 |
| 1720084163 | Lifelong Medical Care | Family Medicine | 2031 6th St, Berkeley, CA 94710-2006 | 2005-06-21 |
| 1689670002 | Lifelong Medical Care | Family Medicine | 3260 Sacramento St, Berkeley, CA 94702-2739 | 2005-06-21 |
| 1952943979 | Lifelong Medical Care | Non-Pharmacy Dispensing Site | 616 16th St, Oakland, CA 94612-1205 | 2019-10-10 |
| 1760024780 | Lifelong Medical Care | Non-Pharmacy Dispensing Site | 2023 Vale Rd Ste 107, San Pablo, CA 94806-3891 | 2019-10-10 |
| Street Address |
386 14TH ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94612-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013084607 | Aislinn Bird | Psychiatry & Neurology | 386 14th St, Oakland, CA 94612-3211 | 2006-11-29 |
| 1477034056 | Cornelliss Taylor | Social Worker | 386 14th St, Oakland, CA 94612-3211 | 2018-08-22 |
| 1205328838 | Jeffrey Chubb | Nurse Practitioner | 386 14th St, Oakland, CA 94612-3211 | 2018-05-30 |
| 1033655519 | Leslie Stavig | Registered Nurse | 386 14th St, Oakland, CA 94612-3211 | 2017-01-09 |
| 1790233047 | Stacy Dearborne | Community Health Worker | 386 14th St, Oakland, CA 94612-3211 | 2016-09-15 |
| 1023563509 | Lakeshia Bell | Community/Behavioral Health | 386 14th St, Oakland, CA 94612-3211 | 2016-08-24 |
| 1811282833 | Rina Breakstone | Social Worker | 386 14th St, Oakland, CA 94612-3211 | 2011-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766284 | Olivia Vega | Behavior Technician | 155 Grand Ave Suite 500, Oakland, CA 94612 | 2020-09-25 |
| 1700418001 | Thera Share | Counselor | 1714 Franklin St #411, Oakland, CA 94612 | 2020-02-05 |
| 1386284644 | Nicole Yolanda Satterfield | Behavioral Analyst | 180 Grand, Oakland, CA 94612 | 2020-01-14 |
| 1992365514 | Integrative Fertility | Acupuncturist | 449 15th St, #101, Oakland, CA 94612 | 2019-06-17 |
| 1578029500 | Emma Noble | Hearing Instrument Specialist | 2201 Broadway Ste 328, Oakland, CA 94612 | 2019-02-14 |
| 1992299143 | Lutchmia Lizonia Engelbrecht | Community Health Worker | 160 14th St Apt 501, Oakland, CA 94612 | 2018-06-20 |
| 1417446444 | Ruth L Richards | Psychiatry & Neurology | 475 Fourteenth St, Ninth Floor, Oakland, CA 94612 | 2018-05-04 |
| 1033618384 | Thomas Plumber | Case Manager/Care Coordinator | 1389 Jefferson St Oakland California Apt D210, Oakland, CA 94612 | 2018-02-01 |
| 1992221774 | Victoria Davina Casillas | Counselor | 559 16th Street, Oakland, CA 94612 | 2017-08-14 |
| 1356864854 | Mackenzie Sodestrom | Marriage & Family Therapist | 287 17th St Ste 205, Oakland, CA 94612 | 2017-07-17 |
| Find all providers in zip 94612 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952942575 | Roots Community Health Center | Family Medicine | 583 5th St Ste A, Oakland, CA 94607 | 2019-10-04 |
| 1699287334 | Ann Blackwell | Family Medicine | 7312 Hillmont Dr, Oakland, CA 94605-2928 | 2017-11-03 |
| 1134579170 | Jonathan Patberg | Family Medicine | 350 Hawthorne Ave Rm 2308, Oakland, CA 94609-3108 | 2016-06-21 |
| 1003279068 | Van T Vu | Family Medicine | 250 E 18th Street, 2nd Floor, Oakland, CA 94606-1716 | 2016-03-29 |
| 1831559509 | Hospital & Medical Foundation of Paris, Inc. | Family Medicine | 5 S. Walnut St., Oakland, IL 61943 | 2016-02-24 |
| 1356729826 | Carroll-anne Heins | Family Medicine | 3600 Broadway Ste 43, Oakland, CA 94611-5730 | 2015-05-15 |
| 1568849743 | Wei (wendy) Diao | Family Medicine | 1800 Harrison St Fl 9th, Oakland, CA 94612 | 2015-04-27 |
| 1902292030 | Xiaoshuang Chen | Family Medicine | 835 Webster Street, Oakland, CA 94607-4219 | 2015-04-15 |
| 1356734859 | Christina Gomez-mira | Family Medicine | 532 Chetwood St, Oakland, CA 94610-1428 | 2015-03-09 |
| 1669875498 | Richard Kreutzer | Family Medicine | 7100 Homewood Dr, Oakland, CA 94611-1411 | 2014-10-07 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.