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
250 BON AIR RD, GREENBRAE, CA 94904-1702
(415) 448-1500
(415) 461-4229
Mailing address
300 PROFESSIONAL CENTER DR, STE 311, NOVATO, CA 94947-4334
(415) 448-1531
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1100366
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100366
DHS LICENSE - GREENBRAE
CA
05
—
FHC11975
—
CA
Enumeration date
05/27/2005
Last updated
06/27/2025
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