Request Credentialing for Organizational/Agency Providers
To request credentialing for a staff member who works within an Organization/Agency, you should:
1. Download the attached pdf file
2. Enter information on Page 1
3. Submit the form to avataraccounts@sfdph.org (from there, Avatar accounts will forward to BHS Credentialing).
Request Credentialing for Private Provider Network
To request credentialing for an individual working in our Private Provider Network, you should:
1. Use this link to our webform--you will enter your name, NPI number and your email address
2. Monitor your email--you will receive an email from "noreply@sfdph.org" within 48-72 hours
3. When you receive the email, open the email--and then click the URL link for MD Staff
4. Use the web-based MD Staff software to enter information and to sign the required forms
Communicate Staff Separation from Organization or PPN
To communicate staff separation for your staff member, you should:
1. Download the attached pdf file
2. Enter information on Page 2
3. Submit this form to credentialing@sfdph.org and carbon copy (cc) the email to avataraccounts@sfdph.org