Provider Demographics
NPI:1811045982
Name:MARIN COUNTY OFFICE OF EDUCATION
Entity Type:Organization
Organization Name:MARIN COUNTY OFFICE OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNTY SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:
Authorized Official - First Name:MARY JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-472-4110
Mailing Address - Street 1:2777 DEL MONTE ST
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-3811
Mailing Address - Country:US
Mailing Address - Phone:916-375-1707
Mailing Address - Fax:
Practice Address - Street 1:1111 LAS GALLINAS AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94913-4925
Practice Address - Country:US
Practice Address - Phone:415-472-4110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA21-10215OtherMEDI-CAL