BAYSIDE MARIN, INC. (NPI# 1417495623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417495623 |
| Entity Type | Organization |
| Organization Name | BAYSIDE MARIN, INC. |
| Other Organization Name | BAYSIDE MARIN OUTPATIENT |
| Practice Address |
718 4th St San Rafael CA 94901-3213 |
| Practice Telephone | 4154500031 |
| Mailing Telephone | 4154500031 |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |
| Authorized Official Name | MR. CHRISTOPHER HOWARD (VP AND SECRETARY) |
| Authorized Official Telephone | 6158616000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
210030CP | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bayside Marin Outpatient | Other Name - Individual/Organization |
| Street Address |
718 4TH ST |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-3213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801041074 | Bayside Marin, LLC | Substance Abuse Rehabilitation Facility | 718 4th St, San Rafael, CA 94901-3213 | 2008-12-01 |
| 1588137434 | Amanda Adams | Nurse Practitioner | 718 4th St, San Rafael, CA 94901-3213 | 2019-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1790288892 | Monroe Operations, LLC | Clinic/Center | 1104 Lincoln Ave, San Rafael, CA 94901-3245 | 2018-03-14 |
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| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
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| 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.