LIFELONG MEDICAL CARE RICHMOND CLINIC (NPI# 1699029330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699029330 |
| Entity Type | Organization |
| Organization Name | LIFELONG MEDICAL CARE RICHMOND CLINIC |
| Practice Address |
2400 Nevin Ave Richmond CA 94804-1700 |
| Mailing Address |
Po Box 11247 Berkeley CA 94712-2247 |
| Practice Telephone | 5102155001 |
| Practice Fax Number | 5102151115 |
| Mailing Telephone | 5102155001 |
| Mailing Fax Number | 5102151115 |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |
| Authorized Official Name | MR. RICK CLARK (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5109814122 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Street Address |
2400 NEVIN AVE |
| City | RICHMOND |
| State | CA |
| Zip Code | 94804-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396385654 | Jennifer Phan | Behavior Technician | 865 Marina Bay Pkwy Ste 37 & 38, Richmond, CA 94804 | 2020-01-14 |
| 1033769104 | Marc Anthony Garcia | Behavioral Analyst | 865 Marina Bay Parkway, Suite 37 & 38, Richmond, CA 94804 | 2019-09-19 |
| 1447818216 | Bay Area Community Services | Community/Behavioral Health | 3215/3221 Nevin Avenue, Richmond, CA 94804 | 2019-06-05 |
| 1558832709 | Eliseo Matthew Beltran Ong | Behavior Technician | 865 Marina Bay Parkway Building C, Suite 37 & 38, Richmond, CA 94804 | 2018-12-16 |
| 1679064943 | Katherine Bacher | Counselor | 200 24th Str., Richmond, CA 94804 | 2018-05-22 |
| 1508353160 | Aveida Home Care LLC | In Home Supportive Care | 302 S 18th Street, Richmond, CA 94804 | 2018-04-19 |
| 1427577980 | Adam Hudson | Counselor | 3215 Nevin Avenue, Richmond, CA 94804 | 2017-09-15 |
| 1205176583 | Anna Fisher | Counselor | 32 Shoreline Ct, Richmond, CA 94804 | 2013-02-22 |
| 1366744328 | Che Hoskins | Counselor | 820 23rd St., Richmond, CA 94804 | 2010-11-24 |
| 1558671297 | Angela May Gaiser | Case Manager/Care Coordinator | 2500 Bissell Avenue, Richmond, CA 94804 | 2010-10-15 |
| Find all providers in zip 94804 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578194049 | Meridian Health Services Corp | Clinic/Center | 520 S 9th St Ste A, Richmond, IN 47374-6230 | 2020-02-03 |
| 1649825092 | The Daily Planet Inc | Clinic/Center | 1532 High St, Richmond, VA 23220-2314 | 2019-08-02 |
| 1528539590 | Meridian Health Services Corp | Clinic/Center | 498 Nw 18th St., Bldg 416 Sted D, Bldg 416 Ste D, Richmond, IN 47374-2851 | 2018-12-17 |
| 1861909731 | The Daily Planet Inc | Clinic/Center | 2864 Hull St, Richmond, VA 23224-3680 | 2018-01-02 |
| 1689186785 | Meridian Health Services Corp | Clinic/Center | 630 E Main Street, Suite 200, Richmond, IN 47374-4358 | 2017-10-30 |
| 1962950584 | Vernon J Harris East End Community Health Center | Clinic/Center | 1800 Lynhaven Ave, Richmond, VA 23224-7734 | 2016-09-12 |
| 1184177743 | Vernon J Harris East End Community Health Center | Clinic/Center | 7945 Forest Hill Ave, Richmond, VA 23225-1932 | 2016-08-01 |
| 1760833008 | Vernon J Harris East End Community Health Center | Clinic/Center | 1718 Williamsburg Rd, Richmond, VA 23231-3428 | 2016-06-28 |
| 1659669596 | The Daily Planet Inc | Clinic/Center | 700 Dinwiddie Ave, Richmond, VA 23224-5522 | 2011-07-13 |
| 1396078135 | Vernon J Harris East End Community Health Center | Clinic/Center | 2711 Byron St, Richmond, VA 23223-1313 | 2009-09-11 |
| Find all providers in RICHMOND | ||||
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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.