Provider Demographics
NPI:1053341396
Name:SEQUOIA LIVING INC
Entity type:Organization
Organization Name:SEQUOIA LIVING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:MI NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-202-7814
Mailing Address - Street 1:1525 POST STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-6567
Mailing Address - Country:US
Mailing Address - Phone:415-202-7800
Mailing Address - Fax:415-922-2338
Practice Address - Street 1:1400 GEARY BOULEVARD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6569
Practice Address - Country:US
Practice Address - Phone:415-922-9700
Practice Address - Fax:415-567-2576
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEQUOIA LIVING INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-03
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000066314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056071Medicare Oscar/Certification
056071Medicare ID - Type Unspecified