MEDICARE: SEQUOIA ALLIANCE

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1942137872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEQUOIA ALLIANCE

Provider Business Mailing Address
First Line	:	7106 DALLAS RD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55430-1314
Country	:	US
Telephone Number	:	612-499-7489
Fax Number	:

Provider Business Practice Location Address
First Line	:	7106 DALLAS RD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55430-1314
Country	:	US
Telephone Number	:	612-499-7489
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MALINDA-MAE PESCHONG
Credential	:
Telephone Number	:	612-499-7489

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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