Healthcare Provider Details

I. General information

NPI: 1477534378
Provider Name (Legal Business Name): GOLDEN GATE PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 DIGITAL DR STE 200
NOVATO CA
94949-8705
US

IV. Provider business mailing address

8 DIGITAL DR STE 2
NOVATO CA
94949-5752
US

V. Phone/Fax

Practice location:
  • Phone: 415-455-9042
  • Fax: 415-455-9318
Mailing address:
  • Phone: 415-455-9042
  • Fax: 415-455-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NICOLE MARIE CLAUSEN
Title or Position: PIC / DIRECTOR
Credential:
Phone: 415-455-9042