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LIFELONG BROOKSIDE COMMUNITY HEALTH CENTER SAN PABLO
NPI 1487696191
Clinic/Center - Community Health in San Pablo, CA

Active since June 10, 2006CLIA 05D2349145 · Waiver
2023 VALE RD, STE 107, SAN PABLO, CA 94806(510) 215-9092(510) 412-9867 Get Directions Write a Review

NPPES record last updated: June 6, 2012. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Lifelong Brookside Community Health Center San Pablo NPPES

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

LIFELONG BROOKSIDE COMMUNITY HEALTH CENTER SAN PABLO (NPI 1487696191) is a healthcare organization registered as a community health in San Pablo, California and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through August 16, 2028 and lists Marty Lynch, Ceo, as its authorized official.

NPPES Registry Identity

NPI1487696191
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameLIFELONG MEDICAL CARE
Location Address2023 VALE RD, STE 107San Pablo, CA 94806-3891
Mailing AddressPo Box 11247Berkeley, CA 94712-2247 · (510) 981-4100 · Fax (510) 981-4193
Phone(510) 215-9092
Fax(510) 412-9867
Organization SubpartYes
Authorized OfficialMarty LynchCeo · (510) 981-4100
Enumeration DateJune 10, 2006
Last NPPES UpdateJune 6, 2012
✔ NPI 1487696191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
2023 VALE RD, San Pablo, CA 94806
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Other Names 1

Doing Business AsLifelong Brookside Community Health Center San Pablo

Other Identifiers 5

Medicare UPINF95254
Medicare UPINF88997
Medicare ID-Type Unspecified551837CA
Medicare UPINH76589CA
Medicare UPINE32511

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2349145

Lifelong Brookside San Pablo - Towne Center · San Pablo, CA
Active · expires Aug 16, 2028
CLIA Number05D2349145
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 17, 2026
Certificate Expiration DateAugust 16, 2028
Laboratory DirectorKimberly Ceci
Laboratory Phone(510) 981-4100
Laboratory LocationLifelong Brookside San Pablo - Towne Center100A San Pablo Towne Center, San Pablo, CA 94806
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

DR. MANOJ SUMANLAL DESAI M.D.
Specialist
2023 VALE RD, SUITE # 1
SAN PABLO, CA 94806
Contra Costa County (510) 237-3785
DARCY STANLEY CNM/WHNP
Advanced Practice Midwife
2023 VALE RD
SAN PABLO, CA 94806
Contra Costa County (510) 215-9092
AUDREY I SCHAPS NP
Family Medicine
2023 VALE RD
SAN PABLO, CA 94806
Contra Costa County (510) 231-9800
JENNIFER RUIZ
Social Worker (Clinical)
2023 VALE RD
SAN PABLO, CA 94806
Contra Costa County (510) 981-4100
MOLLY ANNE MEKJAVICH CNM
Midwife
2023 VALE RD
SAN PABLO, CA 94806
Contra Costa County (510) 215-9092
BROOKSIDE COMMUNITY HEALTH CENTER, INC
Clinic/Center (Community Health)
2023 VALE RD, SUITE 107
SAN PABLO, CA 94806
Contra Costa County (510) 231-9810
TENZIN YOUDON LCSW
Social Worker (Clinical)
2023 VALE RD
SAN PABLO, CA 94806
Contra Costa County (510) 215-9092
OTIS EUGENE ROUNDS MD
Hospitalist
2023 VALE RD, SUITE 211
SAN PABLO, CA 94806
Contra Costa County (510) 231-0955

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 Medical Care's NPI number?

The NPI number for Lifelong Medical Care is 1487696191. It was assigned to this organization in the NPPES registry on June 10, 2006. The provider is doing business as Lifelong Brookside Community Health Center San Pablo.

Where is Lifelong Medical Care located?

Lifelong Medical Care is located at 2023 Vale Rd Ste 107, San Pablo, CA 94806. The listed phone number is (510) 215-9092.

What is Lifelong Medical Care's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Lifelong Medical Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2349145) is associated with this NPI, valid through August 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lifelong Medical Care was last updated on June 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.