NPIMap

Organization Active NPI

County of Marin

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Rafael, CA
National Provider Identifier
1891968855
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
3270 Kerner Boulevard
Building a
San Rafael, CA 94901-4841
Phone
(415) 473-7818
Fax
(415) 473-4283
NPI assigned
Apr 10, 2008
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CA Primary

Addresses

Primary practice location

3270 Kerner Boulevard
Building a
San Rafael, CA 94901-4841

Mailing address

20 N San Pedro Rd
San Rafael, CA 94903-4188
Phone (415) 473-6948

Other identifiers 2

IdentifierTypeStateIssuer
000002177MedicaidCA
2177MedicaidCA

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

Locations

920 Grand Ave
San Rafael, CA 94901
Phone (415) 376-2310

Practitioners & affiliated clinicians

Practitioners 7

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": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1891968855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N SAN PEDRO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034188",
            "telephone_number": "415-473-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 KERNER BOULEVARD",
            "address_2": "BUILDING A",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014841",
            "telephone_number": "415-473-7818",
            "fax_number": "415-473-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MARIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF MARIN",
        "enumeration_date": "2008-04-10",
        "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": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000002177",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177",
            "state": "CA"
        }
    ],
    "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 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.