NPIMap

Organization Active NPI

Muir Wood LLC

  • Psychiatric Residential Treatment Facility
  • Petaluma, CA
National Provider Identifier
1235722059
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
MUIR WOOD LLC
Practice address
402 Rebecca Dr
Petaluma, CA 94952-1784
Phone
(415) 497-7222
NPI assigned
Feb 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Bryan Bowen
Title
Chief Operating Officer
Phone
(415) 497-7722

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

402 Rebecca Dr
Petaluma, CA 94952-1784

Mailing address

201 1St St Ste 111
Petaluma, CA 94952-4291
Phone (415) 497-7722

Other identifiers 1

IdentifierTypeStateIssuer
422794167OtherCACOMMERCIAL

Other names 1

  • Muir Wood Adolescent and Family Services Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2320841Muir Wood Adolescent and Family Services402 Rebecca Dr, Petaluma, CA 94952Certificate of waiverMar 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Muir Wood LLC22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1235722059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 1ST ST STE 111",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949524291",
            "telephone_number": "415-497-7722",
            "fax_number": "707-781-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 REBECCA DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949521784",
            "telephone_number": "415-497-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUIR WOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-12",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "415-497-7722"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "422794167",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Muir Wood Adolescent and Family Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Muir Wood Adolescent and Family Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.