DONALD WAYNE MARLATT RAS NPI 1972870640

NPI Information

NPI: 1972870640
Provider Name: DONALD WAYNE MARLATT, RAS
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Individual
Address:
603 D ST
SAN RAFAEL, CA
ZIP 94901
Phone: (415) 454-9444
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Donald Wayne Marlatt, RAS is a substance abuse rehabilitation facility in San Rafael, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. Donald Wayne Marlatt, RAS NPI is 1972870640. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

603 D ST
SAN RAFAEL, CA
ZIP 94901-719
Phone: (415) 454-9444

The enumeration date for this NPI number is 11/24/2011 and was last updated on 11/24/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		03-097228	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	M1105070241	OTHER	CALIFORNIA	BREINING INSTITUTE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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