Provider Demographics
NPI:1306017512
Name:MARIN COUNTY JUVENILE PROBATION
Entity Type:Organization
Organization Name:MARIN COUNTY JUVENILE PROBATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF ADMIN. SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMUDIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-499-6593
Mailing Address - Street 1:4 JEANNETTE PRANDI WAY
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-1133
Mailing Address - Country:US
Mailing Address - Phone:415-499-6659
Mailing Address - Fax:
Practice Address - Street 1:4 JEANNETTE PRANDI WAY
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-1133
Practice Address - Country:US
Practice Address - Phone:415-499-6659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health