LIFELONG JENKINS PEDIATRIC CENTER
NPI 1407109622
Clinic/Center - Federally Qualified Health Center (FQHC) in Richmond, CA

Q: What is Lifelong Jenkins Pediatric Center's NPI number?

The NPI number for Lifelong Jenkins Pediatric Center is 1407109622. It was assigned to this organization in the NPPES registry on October 25, 2012.

Q: What is Lifelong Jenkins Pediatric Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since October 25, 2012

120 BROADWAY, SUITE 4, RICHMOND, CA 94804(510) 237-9537(510) 237-3957 Get Directions Write a Review

NPPES record last updated: October 25, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lifelong Jenkins Pediatric Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFELONG JENKINS PEDIATRIC CENTER (NPI 1407109622) is a healthcare organization registered as a federally qualified health center (fqhc) in Richmond, California and active in the NPI registry since October 2012. The organization lists Rick Clark, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1407109622

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameLIFELONG JENKINS PEDIATRIC CENTER

Location Address120 BROADWAY, SUITE 4Richmond, CA 94804-1938

Mailing AddressPo Box 11247Berkeley, CA 94712-2247 · (510) 981-4122

Phone(510) 237-9537

Fax(510) 237-3957

Organization SubpartNo

Authorized OfficialRick ClarkChief Financial Officer · (510) 981-4122

Enumeration DateOctober 25, 2012

✔ NPI 1407109622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

120 BROADWAY, Richmond, CA 94804

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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAYLENE ANESOIR MD

Pediatrics

120 BROADWAY, SUITE 4
RICHMOND, CA 94804

Contra Costa County (510) 237-9537

PATRICIA A THOMAS PA-C

Physician Assistant

120 BROADWAY, STE 23
RICHMOND, CA 94804

Contra Costa County (510) 236-7243

DAVID WREN, JR., M.D., INC

Specialist

120 BROADWAY, SUITE 21
RICHMOND, CA 94804

Contra Costa County (510) 235-9014

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifelong Jenkins Pediatric Center's NPI number?

The NPI number for Lifelong Jenkins Pediatric Center is 1407109622. It was assigned to this organization in the NPPES registry on October 25, 2012.

Where is Lifelong Jenkins Pediatric Center located?

Lifelong Jenkins Pediatric Center is located at 120 Broadway Suite 4, Richmond, CA 94804. The listed phone number is (510) 237-9537.

What is Lifelong Jenkins Pediatric Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Lifelong Jenkins Pediatric Center was last updated on October 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.