Provider Demographics
NPI:1679764070
Name:SEQUOIA COMMUNITY HEALTH FOUNDATION INC
Entity Type:Organization
Organization Name:SEQUOIA COMMUNITY HEALTH FOUNDATION INC
Other - Org Name:SEQUOIA COMMUNITY HEALTH CENTERS - DIV/WHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SYBILLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WAIYAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-457-5837
Mailing Address - Street 1:1945 NORTH FINE AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1528
Mailing Address - Country:US
Mailing Address - Phone:559-457-5835
Mailing Address - Fax:559-457-5892
Practice Address - Street 1:145 NORTH CLARK
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2108
Practice Address - Country:US
Practice Address - Phone:559-457-5919
Practice Address - Fax:559-457-5993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAP71152FOtherDIV/WHC FPACT