NPIMap

Organization Active NPI

Marin County TCM Program

  • Case Management Agency
  • San Rafael, CA
National Provider Identifier
1710167440
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
MARIN COUNTY TCM PROGRAM
Practice address
20 N San Pedro Rd Ste 2027
San Rafael, CA 94903-4158
Phone
(415) 499-6936
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Mrs. Linda F Fortelka
Title
Maa/TCM Coordinator
Phone
(415) 499-6936

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

20 N San Pedro Rd Ste 2027
San Rafael, CA 94903-4158

Mailing address

20 N San Pedro Rd Ste 2027
San Rafael, CA 94903-4158
Phone (415) 499-6936

National Provider Directory

National Provider Directory
Tax ID family
Marin County Health and22 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

Locations

20 N San Pedro Rd
Ste 2027
San Rafael, CA 94903
Phone (415) 499-6936

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1710167440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N SAN PEDRO RD STE 2027",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034158",
            "telephone_number": "415-499-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N SAN PEDRO RD STE 2027",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034158",
            "telephone_number": "415-499-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN COUNTY TCM PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "FORTELKA",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MAA/TCM COORDINATOR",
        "authorized_official_telephone_number": "415-499-6936",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.