NPIMap

Organization Active NPI

County of Marin

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Novato, CA
National Provider Identifier
1679081335
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COUNTY OF MARIN
Practice address
1682 Novato Blvd Ste 105
Novato, CA 94947-7021
Phone
(415) 473-2721
NPI assigned
Jan 16, 2018
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF MARINAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Rosanna Lallana
Title
Compliance Privacy Security Ofcr
Phone
(415) 473-2531

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

1682 Novato Blvd Ste 105
Novato, CA 94947-7021

Mailing address

20 N San Pedro Rd Ste 2021
San Rafael, CA 94903-4158
Phone (415) 473-2721

Other identifiers 1

IdentifierTypeStateIssuer
2177MedicaidCA

Other names 1

  • BHRS Odyssey Program Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000810 CA Part B Supplier - Clinic/Group Practice 1153225065 Receives reassigned benefits from 34 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Rafael, CA; Novato, CA; Point Reyes Station, CA; Greenbrae, CA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Marin County Fire Dept22 organizations share this tax ID, including this one
Part of
Marin County Fire Dept

Other organizations with this tax ID 21

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

View all 21

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1679081335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N SAN PEDRO RD STE 2021",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034158",
            "telephone_number": "415-473-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1682 NOVATO BLVD STE 105",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949477021",
            "telephone_number": "415-473-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MARIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF MARIN",
        "enumeration_date": "2018-01-16",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "LALLANA",
        "authorized_official_first_name": "ROSANNA",
        "authorized_official_title_or_position": "COMPLIANCE PRIVACY SECURITY OFCR",
        "authorized_official_telephone_number": "415-473-2531"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHRS Odyssey Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.