Organization Active NPI

Bayside Marin, Inc.

Doing business as Bayside Marin

  • Adult Mental Health Clinic/Center
  • San Rafael, CA
National Provider Identifier
1063110229
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BAYSIDE MARIN, INC.
Doing business as
Bayside Marin
Practice address
718 4TH St
San Rafael, CA 94901-3213
Phone
(800) 757-7131
Fax
(415) 454-3535
NPI assigned
Feb 17, 2023
Last updated
Dec 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian Farley
Title
Vice President and Secretary
Phone
(615) 861-6000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

718 4TH St
San Rafael, CA 94901-3213

Mailing address

4020 Aspen Grove Dr Ste 900
Franklin, TN 37067-3134
Phone (615) 861-6000

Other names 1

  • Bayside Marin Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bayside Marin3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1063110229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 ASPEN GROVE DR STE 900",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673134",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 4TH ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013213",
            "telephone_number": "800-757-7131",
            "fax_number": "415-454-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE MARIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "VICE PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayside Marin",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bayside Marin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.