Provider Demographics
NPI:1841060886
Name:SEQUOIA BEHAVIORAL HEALTH A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity type:Organization
Organization Name:SEQUOIA BEHAVIORAL HEALTH A PROFESSIONAL PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAYDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-446-6281
Mailing Address - Street 1:C/O PREMIER VALLEY BANK, PO BOX 45992
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0992
Mailing Address - Country:US
Mailing Address - Phone:559-667-4111
Mailing Address - Fax:
Practice Address - Street 1:3742 W MINERAL KING AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5530
Practice Address - Country:US
Practice Address - Phone:559-667-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health