MARIN CITY HEALTH AND WELLNESS CENTER (NPI# 1457888299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457888299 |
| Entity Type | Organization |
| Organization Name | MARIN CITY HEALTH AND WELLNESS CENTER |
| Practice Address |
880 Las Gallinas Ave Suite 2 San Rafael CA 94903 |
| Mailing Address |
630 Drake Ave Sausalito CA 94965-1107 |
| Practice Telephone | 4153398813 |
| Mailing Telephone | 4153398813 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-07-11 |
| Authorized Official Name | JAYVON MUHAMMAD (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4153398813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
55000861 | CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467810747 | Marin City Health and Wellness Center | Clinic/Center | 6301 3rd St, San Francisco, CA 94124-3501 | 2016-02-02 |
| 1932629334 | Marin City Health and Wellness Center | Clinic/Center | 630 Drake Ave, Sausalito, CA 94965-1107 | 2017-06-27 |
| 1982080495 | Marin City Health and Wellness Center | Clinic/Center | 880 Las Gallinas Ave, Suite #1, San Rafael, CA 94903-3437 | 2015-08-06 |
| 1962845131 | Marin City Health and Wellness Center | Clinic/Center | 1601 2nd St, Suite 108, San Rafael, CA 94901-2712 | 2013-04-08 |
| 1285804948 | Marin City Health and Wellness Center | Community/Behavioral Health | 630 Drake Ave, Sausalito, CA 94965-1107 | 2008-03-08 |
| Street Address |
880 LAS GALLINAS AVE SUITE 2 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033208699 | Jonathan Smith | Chiropractor | 880 Las Gallinas Ave, 6, San Rafael, CA 94903-3437 | 2006-10-12 |
| 1942679527 | Katerina Koleva | Dentist | 880 Las Gallinas Ave, Suite 5, San Rafael, CA 94903-3437 | 2015-09-24 |
| 1982080495 | Marin City Health and Wellness Center | Clinic/Center | 880 Las Gallinas Ave, Suite #1, San Rafael, CA 94903-3437 | 2015-08-06 |
| 1316288194 | Donna Marie Scippa | Nurse Practitioner | 880 Las Gallinas Ave, Suite 1, San Rafael, CA 94903-3437 | 2013-03-04 |
| 1215202395 | Martin Borge D C, P C | Chiropractor | 880 Las Gallinas Ave, Suite 1, San Rafael, CA 94903-3437 | 2012-03-21 |
| 1023144367 | Anthony D Collard | Dentist | 880 Las Gallinas Ave, Suite #5, San Rafael, CA 94903 | 2007-02-23 |
| 1518021757 | Linda J Crothers | Psychologist | 880 Las Gallinas Ave, San Rafael, CA 94903-3437 | 2006-12-21 |
| 1619057700 | Stephen Peter Zilber | Acupuncturist | 880 Las Gallinas Ave, Suite #1, San Rafael, CA 94903-3437 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1417370032 | Ritter Center | Clinic/Center | 16 Ritter St, San Rafael, CA 94901-3323 | 2014-02-03 |
| 1962845131 | Marin City Health and Wellness Center | Clinic/Center | 1601 2nd St, Suite 108, San Rafael, CA 94901-2712 | 2013-04-08 |
| 1922303437 | Marin Community Clinic | Clinic/Center | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2011-01-13 |
| 1154503399 | Marin Community Clinic | Clinic/Center | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2007-11-29 |
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| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
Please comment or provide details below to improve the information on MARIN CITY HEALTH AND WELLNESS CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.