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General NPI Number Information
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NPI Number | 1770568347
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Entity Type | Organization
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Legal Business Name | GOLDEN VALLEY HEALTH CENTER
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 301 HOWARD RD
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City | WESTLEY
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State | CA
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Zip | 95387-0068
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Country | US
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Telephone | 209-894-3141
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Fax | 209-894-3082
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Provider Business Mailing Address
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Address Line | 1910 CUSTOMER CARE WAY
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City | ATWATER
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State | CA
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Zip | 95301-5167
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Country | US
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Telephone | 209-722-4842
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Fax |
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Authorized Official
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Title or Position | CEO AND PRESIDENT
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Name | DAVID QUACKENBUSH
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Credential |
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Telephone | 209-913-2261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 03000065
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License Number State | CA
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