| Marin County Juvenile Services | |
|
4 Jeannette Prandi Way Orientation Conference Rm & Counseling Rm San Rafael CA 94903-1133 | |
| (415) 499-6659 | |
| Not Available |
| Full Name | Marin County Juvenile Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4 Jeannette Prandi Way, San Rafael, California |
| Authorized Official Name and Position | Donald Bruce Blasky (CHIEF PROGRAM OFFICER) |
| Authorized Official Contact | 4157552311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marin County Juvenile Services 171 Carlos Dr San Rafael CA 94903-2005 Ph: (415) 755-2305 | Marin County Juvenile Services 4 Jeannette Prandi Way Orientation Conference Rm & Counseling Rm San Rafael CA 94903-1133 Ph: (415) 499-6659 |
| NPI Number | 1194044966 |
|---|---|
| Provider Enumeration Date | 05/19/2010 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194044966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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