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General NPI Number Information
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NPI Number | 1780711150
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Entity Type | Organization
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Legal Business Name | SEQUOIA COMMUNITY HEALTH FOUNDATION
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1350 S ORANGE AVE
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City | FRESNO
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State | CA
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Zip | 93702-3463
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Country | US
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Telephone | 559-457-5400
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Fax | 559-457-5491
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Provider Business Mailing Address
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Address Line | 1945 N FINE AVE STE 116
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City | FRESNO
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State | CA
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Zip | 93727-1528
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Country | US
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Telephone | 559-457-5800
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Fax | 559-457-5891
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Authorized Official
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Title or Position | CEO
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Name | JOHN L MAFFEO
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Credential | MD
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Telephone | 559-457-5239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | CA
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