Organization
MARIN COMMUNITY CLINIC
Active
Organization
MARIN COMMUNITY CLINIC
Active
Other names
San Rafael Dental Mobile van
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA SHIPP (CHIEF EXECUTIVE OFFICER)
(415) 475-4572
Entity
Organization
Contact information
Practice address
3110 KERNER BLVD, SAN RAFAEL, CA 94901-5411
(415) 448-1500
Mailing address
3110 KERNER BLVD, SAN RAFAEL, CA 94901-5411
(415) 448-1500
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/06/2024
Last updated
06/27/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up