Healthcare Provider Details

I. General information

NPI: 1720900905
Provider Name (Legal Business Name): GOERTZEN CARE DBA ANDERSSON CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32924 ODOM LN
FORT BRAGG CA
95437-8533
US

IV. Provider business mailing address

32924 ODOM LN
FORT BRAGG CA
95437-8533
US

V. Phone/Fax

Practice location:
  • Phone: 707-964-4040
  • Fax: 707-964-4052
Mailing address:
  • Phone: 707-964-4040
  • Fax: 707-964-4052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. AARON GOERTZEN
Title or Position: C.E.O.
Credential: MA
Phone: 707-357-4640