Contact the Public Authority to get an enrollment packet to enroll as a provider.  You need to contact the Public Authority to get an enrollment packet, there is NO online application if you already have a client you want to work for.

How do I enroll to be a provider?

Please fill out all required paperwork in the enrollment packet and make sure to include:

• A copy of a valid non-expired, government issued ID (e.g., state ID, driver’s license, passport)
• A copy of an original Social Security Card

Mail your enrollment packet to the Public Authority:

Mail: P.O. Box 5892, San Mateo CA 94402

Or call 650 389-9666 to make an appointment to drop off your packet at our office:

Office: 2000 Alameda de las Pulgas, suite 200 

San Mateo, CA 94403