Healthcare Provider Details

I. General information

NPI: 1952279820
Provider Name (Legal Business Name): GHC OF BLUE OAKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11650 EDUCATION STREET
AUBURN CA
95602
US

IV. Provider business mailing address

11650 EDUCATION STREET
AUBURN CA
95602
US

V. Phone/Fax

Practice location:
  • Phone: 530-485-1800
  • Fax:
Mailing address:
  • Phone: 530-485-1800
  • Fax: 714-452-2324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: LOIS MASTROCOLA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 714-241-5600