Healthcare Provider Details

I. General information

NPI: 1043142359
Provider Name (Legal Business Name): SEQUOIA BEHAVIORAL HEALTH A PSYCHOLOGY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 E FIR AVE STE 103
FRESNO CA
93720-3840
US

IV. Provider business mailing address

1781 E FIR AVE STE 102
FRESNO CA
93720-3865
US

V. Phone/Fax

Practice location:
  • Phone: 559-667-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAYDEN MOSER
Title or Position: BILLING DIRECTOR
Credential:
Phone: 949-446-6281