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General NPI Number Information
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NPI Number | 1912116252
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Entity Type | Organization
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Legal Business Name | COUNTY OF MARIN
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 3270 KERNER BLVD STE A
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City | SAN RAFAEL
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State | CA
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Zip | 94901-4840
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Country | US
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Telephone | 415-473-3030
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Fax | 415-473-7008
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Provider Business Mailing Address
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Address Line | 10 N SAN PEDRO RD STE 1022
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City | SAN RAFAEL
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State | CA
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Zip | 94903-4155
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Country | US
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Telephone | 415-473-6948
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE PRIVACY OFFICER
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Name | VENUS ANDRADE
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Credential | CHPC
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Telephone | 415-499-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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