NPIMap

Organization Active NPI

Muir Wood, LLC.

  • Adolescent and Children Mental Health Clinic/Center
  • Petaluma, CA
National Provider Identifier
1962016733
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
MUIR WOOD, LLC.
Practice address
320 Washington St
Petaluma, CA 94952-2955
Phone
(415) 497-7722
NPI assigned
Aug 31, 2020
Organization subpart
Yes
Parent organization
MUIR WOOD, LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Bryan Bowen
Title
Chief Operating Officer
Phone
(415) 497-7722

Specialties & licenses 1

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

Addresses

Primary practice location

320 Washington St
Petaluma, CA 94952-2955

Mailing address

201 1St St Ste 111
Petaluma, CA 94952-4291
Phone (415) 497-7722

Other identifiers 1

IdentifierTypeStateIssuer
422794167OtherCACOMMERCIAL

Other names 1

  • Muir Wood Adolescent and Family Services Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2320127Muir Wood Adolescent and Family Services320 Washington St, Petaluma, CA 94952Certificate of waiverMar 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Muir Wood LLC22 organizations share this tax ID, including this one
Part of
Muir Wood LLC

Other organizations with this tax ID 21

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

View all 21

Locations

320 Washington St
Petaluma, CA 94952

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1962016733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 1ST ST STE 111",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949524291",
            "telephone_number": "415-497-7722",
            "fax_number": "707-781-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WASHINGTON ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522955",
            "telephone_number": "415-497-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUIR WOOD, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUIR WOOD, LLC.",
        "enumeration_date": "2020-08-31",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "415-497-7722"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "422794167",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Muir Wood Adolescent and Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.