Healthcare Provider Details

I. General information

NPI: 1770513004
Provider Name (Legal Business Name): SEQUOIA LIVING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 PORTOLA RD
PORTOLA VALLEY CA
94028-7654
US

IV. Provider business mailing address

1525 POST ST
SAN FRANCISCO CA
94109-6567
US

V. Phone/Fax

Practice location:
  • Phone: 650-851-1501
  • Fax: 650-851-5007
Mailing address:
  • Phone: 415-202-7800
  • Fax: 415-922-2338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number220000047
License Number StateCA

VIII. Authorized Official

Name: MS. MI NAN BOYD
Title or Position: CFO
Credential:
Phone: 415-202-7814