BUCKELEW PROGRAMS (NPI# 1619014883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619014883 |
| Entity Type | Organization |
| Organization Name | BUCKELEW PROGRAMS |
| Other Organization Name | FAMILY SERVICE AGENCY OF MARIN A DIVISION OF BUCKELEW PROGRAMS |
| Practice Address |
3000 Bridgeway Suite 205 Sausalito CA 94965-1489 |
| Mailing Address |
555 Northgate Dr Suite 100 San Rafael CA 94903-3680 |
| Practice Telephone | 4153323129 |
| Mailing Telephone | 4154915700 |
| Mailing Fax Number | 4154915750 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2012-12-19 |
| Authorized Official Name | MARGARET HALLETT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4154915700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Service Agency of Marin a Division of Buckelew Programs | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861666794 | Buckelew Programs | Community Based Residential Treatment Facility, Mental Illness | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2008-04-22 |
| 1518012020 | Buckelew Programs | Case Management | 2300 Northpoint Parkway, Santa Rosa, CA 95407 | 2007-01-24 |
| 1972993616 | Buckelew Programs | Community/Behavioral Health | 201 Alameda Del Prado Ste 103, Novato, CA 94949-6698 | 2015-02-03 |
| 1861823262 | Buckelew Programs | Community Based Residential Treatment Facility, Mental Illness | 1109 Sir Francis Drake Blvd, Kentfield, CA 94904-1418 | 2013-12-10 |
| 1659624815 | Buckelew Programs | Community/Behavioral Health | 3270 Kerner Blvd, San Rafael, CA 94901-4840 | 2012-10-24 |
| 1740537992 | Buckelew Programs | Clinic/Center | 201 Alameda Del Prado Ste 201, Novato, CA 94949-6698 | 2012-08-07 |
| 1881987154 | Buckelew Programs | Community/Behavioral Health | 900 5th Ave Ste 150, San Rafael, CA 94901-2928 | 2011-05-19 |
| 1619290376 | Buckelew Programs | Community/Behavioral Health | 914 Mission Ave, 3rd Floor, San Rafael, CA 94901-6106 | 2010-03-10 |
| 1497085146 | Buckelew Programs | Case Management | 914 Mission Ave Fl 3, San Rafael, CA 94901-6106 | 2009-12-31 |
| 1922334622 | Buckelew Programs | Community Based Residential Treatment Facility, Mental Illness | 914 Mission Ave, San Rafael, CA 94901-6106 | 2009-10-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BUCKELEW PROGRAMS | 1401 Los Gamos Dr Ste 240, San Rafael, CA 94903-1835 |
| Street Address |
3000 BRIDGEWAY SUITE 205 |
| City | SAUSALITO |
| State | CA |
| Zip Code | 94965-1489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740599356 | Jessica Josephine Lopez | Counselor | 3000 Bridgeway, Unit 205, Sausalito, CA 94965-1489 | 2010-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093369423 | Claire Myers | Counselor | 630 Drake Avenue, Csd Building, Marin City, CA 94965 | 2019-07-24 |
| 1750624797 | 10 Minute Fitness Inc. | Durable Medical Equipment & Medical Supplies | 3 Harbor Dr. #112, Sausalito, CA 94965 | 2013-03-28 |
| 1548590169 | Jeffrey James Kacirk | Chiropractor | 80 Harrison Ave, #6, Sausalito, CA 94965 | 2010-01-04 |
| 1922213305 | Patrick Hammill Lee | Dentist | 107 Caledonia Street, Suite I, Sausalito, CA 94965 | 2007-05-11 |
| 1811020688 | Parvaneh Bairami | Registered Nurse | 2400 Bridgeway, Suite 200, Sasaulito, CA 94965 | 2007-03-13 |
| 1518027671 | Helen Chandler | Registered Nurse | 13 Braun Court, Sausalito, CA 94965 | 2006-12-11 |
| 1407916224 | Marcus H Small | Marriage & Family Therapist | 639 Drake Ave., Marin City, CA 94965 | 2006-12-11 |
| 1710068085 | Aida C Miles | Dietitian, Registered | 7 Cloudview Trail, Sausalito, CA 94965 | 2006-10-17 |
| 1942308515 | Nancy S. Hollis | Chiropractor | 3a Gate 5 Road, Sausalito, CA 94965 | 2006-09-20 |
| 1205947702 | Edwin J Zinman | Dentist | 220 Bush St, 1600, San Francisco, CA 94965 | 2006-08-31 |
| Find all providers in zip 94965 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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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.