Organization
MARIN FUNCTIONAL MEDICINE LLC
Active
Other names
Marin Functional Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE ROBINSON MS, CDN, NBC-HWC (OWNER, CLINICAL NUTRITIONIST)
(415) 846-1891
Entity
Organization
Contact information
Practice address
22 JULES DR, NOVATO, CA 94947-2015
(415) 846-1891
Mailing address
22 JULES DR, NOVATO, CA 94947-2015
(415) 846-1891
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
04/11/2023
Last updated
08/02/2024
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