Healthcare Provider Details

I. General information

NPI: 1356398416
Provider Name (Legal Business Name): SEQUOIA HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 VETERANS BLVD SUITE A
REDWOOD CITY CA
94063-1408
US

IV. Provider business mailing address

1825 S GRANT ST SUITE 900
SAN MATEO CA
94402-2655
US

V. Phone/Fax

Practice location:
  • Phone: 650-364-1565
  • Fax: 650-366-2590
Mailing address:
  • Phone: 650-817-3181
  • Fax: 650-482-3592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number220000045
License Number StateCA

VIII. Authorized Official

Name: GRATIA BARTON
Title or Position: VP CFO
Credential:
Phone: 650-367-5837