MEDICARE: SEQUOIA LIVING INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	220000047	CA

General Provider Information

NPI Number	:	1770513004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEQUOIA LIVING INC.

Provider Business Mailing Address
First Line	:	1525 POST ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6567
Country	:	US
Telephone Number	:	415-202-7800
Fax Number	:	415-922-2338

Provider Business Practice Location Address
First Line	:	501 PORTOLA RD
Second Line	:
City	:	PORTOLA VALLEY
State	:	CA
Zip	:	94028-7654
Country	:	US
Telephone Number	:	650-851-1501
Fax Number	:	650-851-5007

Authorized Official
Title or Position	:	CFO
Name	:	MS. MI NAN BOYD
Credential	:
Telephone Number	:	415-202-7814

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	02/07/2019

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