Active NPI
Sequoia Living Inc.
- Skilled Nursing Facility
- Portola Valley, CA
National Provider Identifier
1770513004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 220000047
- Legal business name
- SEQUOIA LIVING INC.
- Practice address
- 501 Portola Rd
Portola Valley, CA 94028-7654 - Phone
- (650) 851-1501
- Fax
- (650) 851-5007
- NPI assigned
- Jul 3, 2006
- Organization subpart
- Yes
- Parent organization
- SEQUOIA LIVING INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Mi Nan Boyd
- Title
- Cfo
- Phone
- (415) 202-7814
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 220000047 | CA | Primary |
Addresses
Primary practice location
501 Portola Rd
Portola Valley, CA 94028-7654
Mailing address
1525 Post St
San Francisco, CA 94109-6567
Phone (415) 202-7800
Other names 1
- The Sequoias Portola Valley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120411000429 | CA | Part A Provider - Skilled Nursing Facility | 4486814324 | Practice locations: Portola Valley, CA |
Skilled nursing facility certification: CCN 055466
- Legal name
- SEQUOIA LIVING INC
- Doing business as
- SEQUOIAS PORTOLA VALLEY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Jan 18, 1967
- Last certification
- May 24, 2024
- Beds
- 43
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Sequoia Living LLC
- Organization structure
- Corporation
- Incorporated
- Jan 27, 1958 in CA
- Enrollment address
- 501 Portola Rd
Portola Valley, CA 94028 - Nursing home name
- THE SEQUOIAS
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Sequoias
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- Non profit - Corporation
- Certified
- Jan 18, 1967
- Medicare certification status
- Active
- Certified beds
- 43
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0887930 | Sequoias Portola Valley | Certificate of waiver | Jun 20, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Sequoia Living Inc
- Part of
- Sequoia Living Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- San Francisco, CA
- NPI 1053341396
-
- Skilled Nursing Facility
- Greenbrae, CA
- NPI 1326078650
-
- Skilled Nursing Facility
- San Francisco, CA
- NPI 1558635359
Ownership & related parties
All disclosed owners & managing parties 18
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Charles Shoemake | Corporate Officer | Aug 14, 2020 | |
| Adp of the SNF | Jan 14, 2025 | ||
| Carl Gordon Howie | Corporate Director | May 1, 2011 | |
| David M Jamison | Corporate Director | Jun 1, 2014 | |
| Patricia Lynn | Corporate Director | Apr 29, 2020 | |
| Dianne Jo Spaulding | Corporate Director | May 1, 2014 | |
| Can Chen | Operational/Managerial Control | Oct 1, 2017 | |
| Adp of the SNF | Oct 1, 2017 | ||
| Sequoia Living Inc | 5% Or Greater Direct Ownership Interest | Jan 18, 1967 | 100% |
| Adp of the SNF | Jan 14, 2025 | ||
| Holly Ito | Corporate Director | Oct 25, 2022 | |
| Steven H Herman | Corporate Director | Jan 1, 2017 | |
| Marilyn Suey | Corporate Director | May 22, 2023 | |
| Richard Corriea | Corporate Director | May 19, 2021 | |
| Suzanne Estelle Wasley-Fairley | Operational/Managerial Control | Aug 1, 2022 | |
| Adp of the SNF | Aug 1, 2022 | ||
| Sarah McVey | 5% Or Greater Indirect Ownership Interest | Sep 24, 2019 | |
| Corporate Officer | Sep 24, 2019 | ||
| Operational/Managerial Control | Sep 24, 2019 | ||
| Adp of the SNF | Sep 24, 2019 | ||
| Marianne Lim | Corporate Director | Jul 21, 2020 | |
| Cory Allan Sanderson | Corporate Director | May 29, 2024 | |
| Valerie Agostino | Corporate Director | Dec 7, 2020 | |
| Nancy Mayeda | Corporate Director | Jan 1, 2016 | |
| Martha a Atwood | Adp of the SNF | Jan 3, 1994 |
Owners & managing parties with NPI records 3
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Stanford, CA
- NPI 1942649157
Adp of the SNF, Operational/Managerial Control
-
- Skilled Nursing Facility
- San Francisco, CA
- NPI 1053341396
5% Or Greater Direct Ownership Interest, Adp of the SNF
-
- Skilled Nursing Facility
- Greenbrae, CA
- NPI 1326078650
5% Or Greater Direct Ownership Interest, Adp of the SNF
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Sequoias San Francisco Convalescent Hospital | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Adp of the SNF |
Jun 18, 1969 Dec 12, 2024 |
| The Tamalpais | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 25, 1984 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- San Francisco, CA
- NPI 1053341396
5% Or Greater Direct Ownership Interest, Adp of the SNF
-
- Skilled Nursing Facility
- Greenbrae, CA
- NPI 1326078650
5% Or Greater Direct Ownership Interest
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1549497600000",
"number": "1770513004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 POST ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941096567",
"telephone_number": "415-202-7800",
"fax_number": "415-922-2338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 PORTOLA RD",
"city": "PORTOLA VALLEY",
"state": "CA",
"postal_code": "940287654",
"telephone_number": "650-851-1501",
"fax_number": "650-851-5007"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SEQUOIA LIVING INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SEQUOIA LIVING INC.",
"enumeration_date": "2006-07-03",
"last_updated": "2019-02-07",
"status": "A",
"authorized_official_last_name": "BOYD",
"authorized_official_first_name": "MI NAN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "415-202-7814",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "220000047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Sequoias Portola Valley",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "The Sequoias Portola Valley",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Portola Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.