Healthcare Provider Details

I. General information

NPI: 1588577308
Provider Name (Legal Business Name): GOLDEN YEARS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

25776 PERICLES ST
MISSION VIEJO CA
92691-4665
US

IV. Provider business mailing address

24000 ALICIA PKWY STE 17-257
MISSION VIEJO CA
92691-3929
US

V. Phone/Fax

Practice location:
  • Phone: 949-648-1003
  • Fax: 949-215-6264
Mailing address:
  • Phone: 949-648-1303
  • Fax: 949-215-6264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JUAN JOSE REYES
Title or Position: ADMININSTRATOR
Credential:
Phone: 949-648-1303