Healthcare Provider Details

I. General information

NPI: 1689590812
Provider Name (Legal Business Name): PACIFIC COAST CARE COORDINATION AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S NORFOLK ST STE 350
SAN MATEO CA
94403-1171
US

IV. Provider business mailing address

1900 S NORFOLK ST STE 350
SAN MATEO CA
94403-1171
US

V. Phone/Fax

Practice location:
  • Phone: 650-200-3794
  • Fax:
Mailing address:
  • Phone: 650-200-3794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KARINA PULIDO-ALAS
Title or Position: FOUNDER & CARE COORDINATOR
Credential:
Phone: 650-471-3084