Organization Active NPI

Sequoia Pace, LLC.

  • PACE Provider Organization
  • Fresno, CA
National Provider Identifier
1063988384
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
SEQUOIA PACE, LLC.
Practice address
1649 Van Ness Ave
Fresno, CA 93721-1128
Phone
(650) 242-5908
NPI assigned
Oct 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nicole Butler
Title
Executive Director
Phone
(559) 777-6722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

1649 Van Ness Ave
Fresno, CA 93721-1128

Mailing address

1649 Van Ness Ave
Fresno, CA 93721-1128
Phone (650) 242-5908

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2169632Sequoia Pace, LLC1649 Van Ness Ave, Fresno, CA 93721Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1063988384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211128",
            "telephone_number": "650-242-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211128",
            "telephone_number": "650-242-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUOIA PACE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "559-777-6722"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.