Organization
MARIN COMMUNITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA SHIPP (CHIEF EXECUTIVE OFFICER)
(415) 475-4572
Entity
Organization
Contact information
Practice address
6100 REDWOOD BLVD, NOVATO, CA 94945-4505
(415) 448-1500
(415) 798-3198
Mailing address
9 COMMERCIAL BLVD, SUITE 103, NOVATO, CA 94949-6118
(415) 448-1500
(415) 798-3180
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
110000491
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70941
—
CA
Enumeration date
10/03/2006
Last updated
06/27/2025
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