Due to COVID-19, the enrollment process has changed.
As part of the enrollment process during COVID-19, you must complete the following steps, and mail in the items requested below:
Mail all forms and copies to:
Public Authority Provider Enrollment,
401 Mile of Cars Way, Suite 200,
National City CA 91950
- Call the Provider Enrollment Department at (866) 351-7722 to request an Enrollment packet or click here to submit your request online
- Complete and mail the SOC426 Provider Enrollment Form- do not e-mail
- Complete and mail the SOC426A IHSS Program Recipient Designation of Provider Form (the Consumer must sign this form) – do not e-mail
- Submit fingerprints and undergo a criminal background check by the California Department of Justice “DOJ”
- Provide a copy of your valid U.S. government issued photo identification card
-The name on your photo ID and Social Security card must match - Provide a copy of your original Social Security card
-NO Social Security card receipts accepted - Watch the Mandated Provider Orientation video
*A copy of your Social Security card and U.S. government issued ID can be emailed to enrollment@sdihsspa.com