NPIMap

Organization Active NPI

Family Service Agency of Marin

  • Community/Behavioral Health Agency
  • Mill Valley, CA
National Provider Identifier
1972655678
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY SERVICE AGENCY OF MARIN
Practice address
384 Panoramic Hwy
Mill Valley, CA 94941-2646
Phone
(415) 888-3384
NPI assigned
Jan 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Diane A. Suffridge, PHD.
Title
Clinical Director
Phone
(415) 491-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

384 Panoramic Hwy
Mill Valley, CA 94941-2646

Mailing address

555 Northgate Dr
San Rafael, CA 94903-3680

National Provider Directory

National Provider Directory
Tax ID family
Family Service Agency of Marin6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972655678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 NORTHGATE DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 PANORAMIC HWY",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412646",
            "telephone_number": "415-888-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE AGENCY OF MARIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUFFRIDGE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "415-491-5700",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.