MEDICARE: GOLDEN POND L.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1396686416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN POND L.P.

Provider Business Mailing Address
First Line	:	200 PORTER DR STE 215
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1524
Country	:	US
Telephone Number	:	925-362-0354
Fax Number	:	925-362-8470

Provider Business Practice Location Address
First Line	:	3415 MAYHEW RD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-3100
Country	:	US
Telephone Number	:	916-369-8967
Fax Number	:	916-369-1831

Authorized Official
Title or Position	:	PARTNER
Name	:	MR. BRIAN E WALGENBACH
Credential	:
Telephone Number	:	510-407-0065

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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Directions to “GOLDEN POND L.P. ” Practice Location

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