Provider Demographics
NPI:1356398416
Name:SEQUOIA HEALTH SERVICES
Entity type:Organization
Organization Name:SEQUOIA HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:GRATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-367-5837
Mailing Address - Street 1:1825 S GRANT ST
Mailing Address - Street 2:SUITE 900
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2655
Mailing Address - Country:US
Mailing Address - Phone:650-817-3181
Mailing Address - Fax:650-482-3592
Practice Address - Street 1:633 VETERANS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1408
Practice Address - Country:US
Practice Address - Phone:650-364-1565
Practice Address - Fax:650-366-2590
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEQUOIA HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-27
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000045261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
104617500OtherDOFL - PALO ALTO LOC
G53480OtherDOFL - REDWOOD CITY LOC
91-2152169OtherEIN