NPIMap

Organization Active NPI

County of Marin

  • Clinic/Center
  • San Rafael, CA
National Provider Identifier
1881065332
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COUNTY OF MARIN
Practice address
3230 Kerner Blvd
San Rafael, CA 94901-4840
Phone
(415) 473-5053
NPI assigned
Oct 9, 2015
Organization subpart
Yes
Parent organization
COUNTY OF MARINAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Rosanna Lallana
Title
Compliance/Privacy Officer
Phone
(415) 473-2087

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3230 Kerner Blvd
San Rafael, CA 94901-4840

Mailing address

PO Box 4158
San Rafael, CA 94913-4158
Phone (415) 473-5053

Other identifiers 1

IdentifierTypeStateIssuer
2177MedicaidCA

Other names 1

  • Mental Health Wellness Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Marin County Health and22 organizations share this tax ID, including this one
Part of
Marin County Health and

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1881065332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4158",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949134158",
            "telephone_number": "415-473-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MARIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF MARIN",
        "enumeration_date": "2015-10-09",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "LALLANA",
        "authorized_official_first_name": "ROSANNA",
        "authorized_official_title_or_position": "COMPLIANCE/PRIVACY OFFICER",
        "authorized_official_telephone_number": "415-473-2087"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Health Wellness Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mental Health Wellness Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 18, 2021; 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.