Healthcare Provider Details

I. General information

NPI: 1912875329
Provider Name (Legal Business Name): PENINSULA FAMILY CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 4TH AVE
REDWOOD CITY CA
94063-3726
US

IV. Provider business mailing address

3460 W BAYSHORE RD STE 202
EAST PALO ALTO CA
94303-4270
US

V. Phone/Fax

Practice location:
  • Phone: 669-237-8911
  • Fax:
Mailing address:
  • Phone: 669-237-8911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIC VALLADARES
Title or Position: EXECUTIVE DIRECTOR
Credential: LMFT
Phone: 669-254-5244