| Lifelong William Jenkins Health Center | |
|
150 Harbour Way Richmond CA 94801-3554 | |
| (510) 237-9537 | |
| (510) 981-4191 |
| Full Name | Lifelong William Jenkins Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 150 Harbour Way, Richmond, California |
| Authorized Official Name and Position | David B. Vliet (CEO) |
| Authorized Official Contact | 5109814123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifelong William Jenkins Health Center Po Box 11247 Berkeley CA 94712-2247 Ph: (510) 981-4100 | Lifelong William Jenkins Health Center 150 Harbour Way Richmond CA 94801-3554 Ph: (510) 237-9537 |
| NPI Number | 1407973043 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 01/19/2021 |
| Medicare PECOS PAC ID | 2062304538 |
|---|---|
| Medicare Enrollment ID | O20120425000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407973043 | NPI | - | NPPES |
| FHC71108F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 550000122 (California) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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