NPIMap

Organization Active NPI

San Mateo County

Doing business as Palos Verdes

  • Community/Behavioral Health Agency
  • San Bruno, CA
National Provider Identifier
1093807315
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SAN MATEO COUNTY
Doing business as
Palos Verdes
Practice address
1290 Commodore Dr
San Bruno, CA 94066-2304
Phone
(650) 583-1260
NPI assigned
Sep 28, 2006
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jei Africa
Title
Mental Health Director
Phone
(650) 573-2748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1290 Commodore Dr
San Bruno, CA 94066-2304

Mailing address

1290 Commodore Dr
San Bruno, CA 94066-2304
Phone (650) 583-1260

Other names 1

  • Palos Verdes Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Harold D Chope Allergy123 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

1290 Commodore Dr
San Bruno, CA 94066
Phone (650) 385-9693

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1093807315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 COMMODORE DR",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662304",
            "telephone_number": "650-583-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 COMMODORE DR",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662304",
            "telephone_number": "650-583-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MATEO COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "AFRICA",
        "authorized_official_first_name": "JEI",
        "authorized_official_title_or_position": "MENTAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "650-573-2748"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palos Verdes",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palos Verdes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bruno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.