Marin City Health and Wellness Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MARIN CITY HEALTH AND WELLNESS CENTER

Practice address

6301 3Rd St
San Francisco, CA 94124-3501

Phone

(415) 339-8813

Fax

(415) 339-8814

NPI assigned

Feb 2, 2016

Organization subpart

No

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

Authorized official

Name

Adam Crawford Francis

Title

Cmo

Phone

(415) 339-8813

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467810747. Details of each certification follow.

• CCN 751862 Federally qualified health center · Details

Federally qualified health center certification: CCN 751862

Legal name

MARIN CITY HEALTH AND WELLNESS CENTER

Organization structure

CorporationNon-profit

Incorporated

Apr 25, 2006 in CA

Enrollment address

6301 3Rd St
San Francisco, CA 94124-3501

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Marin City Health and Wellness Center

  dba Perinatal and Women's Health Suite

  • Federally Qualified Health Center (FQHC)
  • Sausalito, CA
  • NPI 1285804948

  1052451259

  Same PAC ID

Tax ID family

Marin City Health and Wellness Center3 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.

• Marin City Health and Wellness Center

  dba Perinatal and Women's Health Suite

  • Federally Qualified Health Center (FQHC)
  • Sausalito, CA
  • NPI 1285804948
  NPD tax ID
• Marin City Health and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Sausalito, CA
  • NPI 1932629334
  NPD tax ID

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Marie Alvarado Denton, PA-C

  • Physician Assistant
  • Stanford, CA
  • NPI 1275216202
  NPD

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1467810747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 DRAKE AVE",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651107",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 3RD ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941243501",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN CITY HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "FRANCIS",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "CRAWFORD",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "415-339-8813"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Denise Marieni, M.D.
• Marilyn Kutzscher MD Inc
• Marilyn M Robertson MD Inc (Marilyn M. Robertson, M.D.)
• Marilyn Marie Robertson, M.D. Inc
• Marin Cardiac Surgery
• Adriana Marin Urrego
• Alex Marin
• Mark S Marin, MD
• Marina Counseling Center
• Marina Harbor Detox

• Federally Qualified Health Center (FQHC) in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.