County of San Mateo
Organization Active NPI Multi-Specialty Clinic/Center · San Mateo, CA
NPI 1114005105 · NPPES record last updated Oct 23, 2025
Key facts
- NPI
- 1114005105
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- COUNTY OF SAN MATEO
- Practice address
- 222 W 39TH Ave
San Mateo, CA 94403-4364 - Phone
- (650) 573-3962
- NPI assigned
- Nov 1, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- COUNTY OF SAN MATEO
Authorized official
- Name
- Jennifer Papa
- Title
- Chief Financial Officer
- Phone
- (650) 573-2613
Other NPIs on the same Medicare enrollment 36
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031126000292 | CA | Part B Supplier - Clinic/Group Practice | 9032023171 |
Receives reassigned benefits from 605 practitioners 36 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Redwood City, CA; San Mateo, CA; San Bruno, CA; South San Francisco, CA; Woodside, CA; Daly City, CA; Belmont, CA; Colma, CA… |
National Provider Directory
- Part of
- Harold D Chope Comm Pat
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
222 W 39TH Ave
San Mateo, CA 94403-4364
Mailing address
222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-3962
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GRE001660 | Medicaid | CA |
Other names
- San Mateo Medical Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in San Mateo, CA
- Jeanie Elizabeth Cotton
- Shawn Michael Cotton
- Alyssa Gianella Coulter
- Counseling for Change: a Psychological Corporation
- County of San Mateo
- County of San Mateo
- County of San Mateo
- County of San Mateo
- County of San Mateo
- County of San Mateo
All providers in San Mateo, CA · Multi-Specialty Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.