Sequoia Psychotherapy Center, Inc

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

License

PSY 13574 Issued in CA

Legal business name

SEQUOIA PSYCHOTHERAPY CENTER, INC

Practice address

1960 N. Gateway Blvd
Fresno, CA 93727

Phone

(559) 266-5200

NPI assigned

Jun 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark David Popper, PH.D.NPI 1306878020

Title

Executive Clinical Director

Phone

(559) 266-5200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Mark David Popper, PH.D.

  • Clinical Psychologist
  • Fresno, CA
  • NPI 1306878020
  Medicare reassignment NPD Authorized official
• Devin E Kowalczyk, PHD, LP

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1316474026
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1427085349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 N. GATEWAY BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93727",
            "telephone_number": "559-266-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 N. GATEWAY BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93727",
            "telephone_number": "559-266-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUOIA PSYCHOTHERAPY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "POPPER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "559-266-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY 13574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sequoia Community Health Foundation, Inc.
• Sequoia Community Health Foundation, Inc.
• Sequoia Community Health Foundation,Inc. (Sequoia Community Health Centers)
• Sequoia Grove Assisted Living Inc
• Sequoia Pace, LLC.
• Sequoia Recovery Center
• Sequoia Sleep Diagnostics Inc.
• Kylee Serafin
• Kynoosh Seraji, MS, CGC
• Linda Jean Sereda

• Group Psychotherapy Psychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Group Psychotherapy Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.