Sequoia Surgical Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

140000649 Issued in CA

Legal business name

SEQUOIA SURGICAL CENTER LP

Doing business as

Sequoia Surgical Pavilion

Practice address

2405 Shadelands Dr
Suite 200
Walnut Creek, CA 94598-2444

Phone

(925) 935-6700

Fax

(925) 935-6690

NPI assigned

Aug 15, 2005

Organization subpart

No

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

Authorized official

Name

Jennifer B Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other names 1

• Sequoia Surgical Pavilion Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospital certification: CCN 050789

Legal name

SEQUOIA SURGICAL CENTER, LP

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

Apr 17, 2020

Last certification

Apr 17, 2020

Beds

1

Ownership / control type

Private (for profit)

Facility address

2405 Shadelands Drive, Suite 200
Walnut Creek, CA 94598

Listed as

Sequoia Surgical PavilionCCN 05C0001515

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tina Michele Hadaway, RN

  • Registered Nurse
  • Lafayette, CA
  • NPI 1922435627
  NPD
• Liam Harris, MD

  • Orthopaedic Surgery of the Spine Physician
  • Concord, CA
  • NPI 1023544327
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1316939556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 SHADELANDS DR",
            "address_2": "SUITE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982444",
            "telephone_number": "925-935-6700",
            "fax_number": "925-935-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 SHADELANDS DR",
            "address_2": "SUITE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982444",
            "telephone_number": "925-935-6700",
            "fax_number": "925-935-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUOIA SURGICAL CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "140000649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sequoia Surgical Pavilion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sequoia Surgical Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elham Senemar, PHARMACIST
• Thearith Seng, M.D.
• Janine E Senior, MD
• Katherine Louise Senti, MFT
• Bianca Sepulveda
• Madeline Serb
• Sergio Florencio Jr, DDS, DMSC, Inc
• Emily Jane Serkin, PH.D.
• Gabrielle Serrano
• Glorence Serrano

• Ambulatory Surgical Clinic/Center in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.