Provider Demographics
NPI:1871651703
Name:SEQUOIA COMMUNITY HEALTH FOUNDATION, INC
Entity Type:Organization
Organization Name:SEQUOIA COMMUNITY HEALTH FOUNDATION, INC
Other - Org Name:SEQUOIA COMMUNITY HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYBILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAIYAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-457-5237
Mailing Address - Street 1:1945 N. FINE AVE, SUITE #116
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727
Mailing Address - Country:US
Mailing Address - Phone:559-457-5236
Mailing Address - Fax:559-457-5891
Practice Address - Street 1:6011 N FRESNO ST
Practice Address - Street 2:SUITE 115
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5274
Practice Address - Country:US
Practice Address - Phone:559-457-6800
Practice Address - Fax:559-457-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000220261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC71144FMedicaid
CAZZZ05847ZOtherMEDICARE PART B/NHIC
CAFHC71144FMedicaid