Provider Demographics
NPI:1295410967
Name:LINEAGE & LEGACY
Entity type:Organization
Organization Name:LINEAGE & LEGACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONFIDANTE
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CPSS
Authorized Official - Phone:408-661-5795
Mailing Address - Street 1:PO BOX 51298
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-0697
Mailing Address - Country:US
Mailing Address - Phone:408-661-5795
Mailing Address - Fax:408-608-3347
Practice Address - Street 1:2512 FARRINGTON WAY
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1118
Practice Address - Country:US
Practice Address - Phone:408-661-5795
Practice Address - Fax:408-608-3347
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HELPING OTHERS MAINTAIN EARTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty