Organization Active NPI

Child Therapy Institute of Marin

  • Community/Behavioral Health Agency
  • Berkeley, CA
National Provider Identifier
1487092144
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHILD THERAPY INSTITUTE OF MARIN
Practice address
2015 Virginia St
Berkeley, CA 94709-2229
Phone
(415) 456-7724
Fax
(415) 456-1050
NPI assigned
Jun 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Authorized official

Name
Brian Lukas
Title
Executive Director
Phone
(415) 456-7724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2015 Virginia St
Berkeley, CA 94709-2229

Mailing address

1480 Lincoln Ave Ste 8
San Rafael, CA 94901-2085
Phone (415) 456-7724

National Provider Directory

National Provider Directory
Tax ID family
Child Therapy Institute21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

2015 Virginia St
Berkeley, CA 94709
Phone (415) 456-1050

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1487092144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 LINCOLN AVE STE 8",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012085",
            "telephone_number": "415-456-7724",
            "fax_number": "415-456-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 VIRGINIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947092229",
            "telephone_number": "415-456-7724",
            "fax_number": "415-456-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD THERAPY INSTITUTE OF MARIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "LUKAS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-456-7724"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.