Donald Wayne Marlatt, RAS

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

03-097228 Issued in CA

Practice address

603 D St
San Rafael, CA 94901-3719

Phone

(415) 454-9444

NPI assigned

Nov 24, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center Point

  • Substance Abuse Rehabilitation Facility
  • San Rafael, CA
  • NPI 1093178279
  NPD (past)

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

{
    "created_epoch": "1322092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322092800000",
    "number": "1972870640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 D ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013719",
            "telephone_number": "415-454-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 D ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013719",
            "telephone_number": "415-454-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLATT",
        "first_name": "DONALD",
        "middle_name": "WAYNE",
        "credential": "RAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-24",
        "last_updated": "2011-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "03-097228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BREINING INSTITUTE",
            "identifier": "M1105070241",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Maria Mariscal, R.N., P.H.N.
• Mark Drucker, D.P.M., a Professional Corporation
• Dallas J Mark
• Alex Stephen Markels, LCSW
• Stephen Marks, PH.D.
• Jonathan Louis Marlowe, PHD
• Jeff Marquardt
• Yolanda Marquez
• Kelly Marshall
• Precious Deneen Marshall

• Substance Abuse Rehabilitation Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2011; 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.