NPIMap

Organization Active NPI

San Mateo County

  • Public Health or Welfare Agency
  • Menlo Park, CA
National Provider Identifier
1104978840
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
SAN MATEO COUNTY
Practice address
795 Willow Rd
BLDG 332
Menlo Park, CA 94025-2539
Phone
(650) 578-7190
NPI assigned
Jan 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Judith DavilaNPI 1952680431
Title
Aod Program Manager
Phone
(650) 802-5057

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

795 Willow Rd
BLDG 332
Menlo Park, CA 94025-2539

Mailing address

400 Harbor Blvd
Building C
Belmont, CA 94002-4047

Other identifiers 1

IdentifierTypeStateIssuer
4191OtherCAPROVIDER NUMBER

Other names 1

  • San Mateo Medical Center - Willow Clinic Other name

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 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104978840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HARBOR BLVD",
            "address_2": "BUILDING C",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD",
            "address_2": "BLDG 332",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-578-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MATEO COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVILA",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "AOD PROGRAM MANAGER",
        "authorized_official_telephone_number": "650-802-5057",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "4191",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Mateo Medical Center - Willow Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.