Healthcare Provider Details

I. General information

NPI: 1770456014
Provider Name (Legal Business Name): GOLDEN GATE MOBILE GERIATRIC CARE, A NURSING P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 N ST # 10310
SACRAMENTO CA
95816-5712
US

IV. Provider business mailing address

2108 N ST # 10310
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 510-399-0793
  • Fax:
Mailing address:
  • Phone: 510-399-0793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CANDACE BLAUSER
Title or Position: PRESIDENT
Credential: NP
Phone: 510-399-0793