MARIN CITY HEALTH AND WELLNESS CENTER (NPI# 1467810747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467810747 |
| Entity Type | Organization |
| Organization Name | MARIN CITY HEALTH AND WELLNESS CENTER |
| Practice Address |
6301 3rd St San Francisco CA 94124-3501 |
| Mailing Address |
630 Drake Ave Sausalito CA 94965-1107 |
| Practice Telephone | 4153398813 |
| Practice Fax Number | 4153398814 |
| Mailing Telephone | 4153398813 |
| Mailing Fax Number | 4153398814 |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-10-18 |
| Authorized Official Name | JAYVON MUHAMMAD (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4153398813 |
| Authorized Official Credential | L.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932629334 | Marin City Health and Wellness Center | Clinic/Center | 630 Drake Ave, Sausalito, CA 94965-1107 | 2017-06-27 |
| 1457888299 | Marin City Health and Wellness Center | Clinic/Center | 880 Las Gallinas Ave, Suite 2, San Rafael, CA 94903 | 2017-05-11 |
| 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 |
6301 3RD ST |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94124-3501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992341762 | Maribel Marin | Nurse Practitioner | 6301 3rd St, San Francisco, CA 94124-3501 | 2019-11-26 |
| 1518325430 | Robyn Malone | Dentist | 6301 3rd St, San Francisco, CA 94124-3501 | 2016-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922597525 | Valeria Elizabeth Diaz | Technician, Other | 1227 Revere Ave, San Francisco, CA 94124 | 2018-05-09 |
| 1164929915 | Derrick Tuckerson | Registered Nurse | 3801 3rd Street #5j93, Suite 200, San Fransisco, CA 94124 | 2018-04-09 |
| 1518469766 | Skycoast Mobility, LLC | Non-emergency Medical Transport (VAN) | 1485 Bayshore Blvd., Suite #320a, San Francisco, CA 94124 | 2018-03-04 |
| 1811419484 | Kayla Leininger | Counselor | 3801 3rd St., 400, San Francisco, CA 94124 | 2017-07-14 |
| 1508240953 | Suzanne Wen | Dentist | 1938 Donner Ave, San Francisco, CA 94124 | 2015-07-15 |
| 1518362201 | Southeast Health Clinic, Department of Public Health | Clinic/Center | 2401 Keith Ave, San Francisco, CA 94124 | 2014-10-24 |
| 1629489299 | Bayview Hunter Point Foundation | Community/Behavioral Health | 1075 Leconte Street, San Francisco, CA 94124 | 2014-05-16 |
| 1558797936 | Mickey Diner Stein | Student in an Organized Health Care Education/Training Program | 3801 Third Street, Suite 400, San Francisco, CA 94124 | 2013-09-18 |
| 1164797916 | Ronnie Muniz | Counselor | 5015 Third Street, San Francisco, CA 94124 | 2012-03-13 |
| 1265717144 | Marq'uis Amari-hakeem Reid | Counselor | 1625 Carroll Avenue, San Francisco, CA 94124 | 2011-10-11 |
| Find all providers in zip 94124 | ||||
| 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 |
|---|---|---|---|---|
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| 1942844477 | North East Medical Services | Clinic/Center | 650 Polk St, San Francisco, CA 94102-3328 | 2019-10-28 |
| 1407490931 | North East Medical Services | Clinic/Center | 1443 Ocean Ave, San Francisco, CA 94112-1731 | 2019-10-28 |
| 1447810734 | North East Medical Services | Clinic/Center | 3431 Taraval St, San Francisco, CA 94116-2050 | 2019-06-18 |
| 1275017691 | North East Medical Services | Clinic/Center | 1422 Noriega St, San Francisco, CA 94122-4432 | 2018-09-21 |
| 1497094858 | City & County of San Francisco | Clinic/Center | 220 Golden Gate Ave, San Francisco, CA 94102-3795 | 2013-02-05 |
| 1598044166 | San Francisco Medical Center Outpatient Improvement Programs, Inc | Clinic/Center | 66 9th St, San Francisco, CA 94103-1427 | 2011-08-12 |
| 1457658734 | North East Medical Services | Clinic/Center | 2308 Taraval St, San Francisco, CA 94116-2252 | 2011-02-22 |
| 1508172842 | Mission Area Health Associates | Clinic/Center | 165 Capp St, San Francisco, CA 94110-1209 | 2010-08-24 |
| 1528136389 | Mission Area Health Associates | Clinic/Center | 4434 Mission St, San Francisco, CA 94112-1927 | 2006-12-01 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94124 |
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.