Healthcare Provider Details

I. General information

NPI: 1689658205
Provider Name (Legal Business Name): KATHLEEN ROSE GOLDEN MCANDREW DNP, MSN, BC, ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 MARINA VILLAGE PKWY STE 101
ALAMEDA CA
94501-1033
US

IV. Provider business mailing address

560 CANYON OAKS DR APT B
OAKLAND CA
94605-5907
US

V. Phone/Fax

Practice location:
  • Phone: 510-227-5540
  • Fax:
Mailing address:
  • Phone: 617-201-6407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number208056
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number22304F
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: