Basic Information
| Provider Information | |||||||||
| NPI: | 1932381548 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEQUOIA COUNSELING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 165 ARCH STREET | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503630383 | ||||||||
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| Practice Location | |||||||||
| Address1: | 165 ARCH STREET | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503630383 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2007 | ||||||||
| LastUpdateDate: | 12/05/2007 | ||||||||
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| AuthorizedOfficialLastName: | GRABIANOWSKI | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER MFT | ||||||||
| AuthorizedOfficialTelephone: | 6503630383 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC25517 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.