Healthcare Provider Details

I. General information

NPI: 1962839803
Provider Name (Legal Business Name): COUNTY OF MARIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2013
Last Update Date: 05/27/2023
Certification Date: 05/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD UNIT B, PSYCHIATRIC EMERGENCY
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

PO BOX 4158
SAN RAFAEL CA
94913-4158
US

V. Phone/Fax

Practice location:
  • Phone: 415-473-6666
  • Fax:
Mailing address:
  • Phone: 415-473-6816
  • Fax: 415-473-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ROSANNA LALLANA
Title or Position: COMPLIANCE/PRIVACY OFFICER
Credential:
Phone: 415-473-2087