Marin Functional Medicine LLC
Nutritionist in Novato, CA. Organization (NPI-2).
NPI number1710672001
StatusActive
Last updated in NPPESAug 2, 2024
Details
- NPI
- 1710672001
- Entity type
- Organization (NPI-2)
- Legal business name
- Marin Functional Medicine LLC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2023
- Certification date
- Aug 2, 2024
- Last updated
- Aug 2, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133N00000X | Nutritionist | – | – | Yes |
| 171400000X | Health & Wellness Coach | – | – | |
| 261QH0100X | Clinic/Center, Health Services | – | – |
Other names
- Marin Functional Nutrition (Former Legal Business Name)
Practice location
22 Jules DrNovato, CA 94947-2015
Phone 415-846-1891
Mailing address
22 Jules DrNovato, CA 94947-2015
Phone 415-846-1891
Authorized official
Diane Robinson
Owner, Clinical Nutritionist
4158461891
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