Marin Brain Injury Network

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

MARIN BRAIN INJURY NETWORK

Practice address

1132 Magnolia Ave
Larkspur, CA 94939-1019

Phone

(415) 461-6771

Fax

(415) 461-8406

NPI assigned

Jan 4, 2016

Organization subpart

No

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

Authorized official

Name

Patricia Gill

Title

Executive Director

Phone

(415) 461-6771

Specialties & licenses 1

Addresses

Other names 1

• Brain Injury Network of the Bay Area Doing business as

Locations

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1467818633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 MAGNOLIA AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391019",
            "telephone_number": "415-461-6771",
            "fax_number": "415-461-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 MAGNOLIA AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391019",
            "telephone_number": "415-461-6771",
            "fax_number": "415-461-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN BRAIN INJURY NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-461-6771"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brain Injury Network of the Bay Area",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Hoagland Madsen, RD
• Jan Ellen Maisel, MD PHD
• Pankaj Malhotra, M.D.
• Arundathi Shenoy Malladi, M.D.
• Katherine Manning, P.T.
• Marin Community Clinic
• Marin Community Clinic
• Marin Healthcare District
• Marin Womens Health
• Sean Kevin Maroney, M.D.

• Adult Day Care Clinic/Center in Larkspur, CA
• Providers in Larkspur, CA by specialty
• Adult Day Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.