Healthcare Provider Details

I. General information

NPI: 1851504443
Provider Name (Legal Business Name): GOLDEN VALLEY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 C ST
PATTERSON CA
95363-2701
US

IV. Provider business mailing address

737 W CHILDS AVE
MERCED CA
95340-6805
US

V. Phone/Fax

Practice location:
  • Phone: 209-892-8441
  • Fax: 209-384-3966
Mailing address:
  • Phone: 209-383-1848
  • Fax: 209-384-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. HELEN ROEHLK
Title or Position: ADMIN. ASSIST. CREDENTIALING
Credential:
Phone: 209-385-5434