1770513004 NPI number — SEQUOIA LIVING INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770513004 NPI number — SEQUOIA LIVING INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEQUOIA LIVING INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE SEQUOIAS PORTOLA VALLEY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770513004
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 PORTOLA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTOLA VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94028-7654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-851-1501
Provider Business Practice Location Address Fax Number:
650-851-5007
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOYD
Authorized Official First Name:
MI NAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
415-202-7814

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  220000047 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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