Healthcare Provider Details

I. General information

NPI: 1114704459
Provider Name (Legal Business Name): COUNTY OF MARIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PETER BEHR DR
SAN RAFAEL CA
94903-5216
US

IV. Provider business mailing address

20 N SAN PEDRO RD
SAN RAFAEL CA
94903-4188
US

V. Phone/Fax

Practice location:
  • Phone: 415-473-6651
  • Fax: 415-473-7505
Mailing address:
  • Phone: 415-473-4163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LISA WARHUUS
Title or Position: ASSISTANT COUNTY EXECUTIVE
Credential:
Phone: 415-473-6196