Healthcare Provider Details

I. General information

NPI: 1962339325
Provider Name (Legal Business Name): GOLDEN AGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3521 EFFINGHAM LN
MODESTO CA
95357-1433
US

IV. Provider business mailing address

3521 EFFINGHAM LN
MODESTO CA
95357-1433
US

V. Phone/Fax

Practice location:
  • Phone: 209-495-2504
  • Fax: 209-593-3105
Mailing address:
  • Phone: 209-495-2504
  • Fax: 209-593-3105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARINELA PLACINTAR
Title or Position: OWNER
Credential:
Phone: 209-495-2504