Golden Valley Health Center
Organization Active NPI Federally Qualified Health Center (FQHC) · Manteca, CA
NPI 1477020121 · NPPES record last updated Feb 27, 2026
Key facts
- NPI
- 1477020121
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- GOLDEN VALLEY HEALTH CENTER
- Practice address
- 302 Northgate Dr
Manteca, CA 95336-3139 - Phone
- (209) 239-5299
- Fax
- (209) 239-5295
- NPI assigned
- Oct 31, 2018
- Organization subpart
- No
Authorized official
- Name
- David Quackenbush
- Title
- Ceo and President
- Phone
- (209) 913-2261
Other NPIs on the same Medicare enrollment 45
Practitioners 13
-
Olatoyosi Grace Akinrotimi, MMS MPH, PA-C
-
Liza J Bryant, PA-C
-
Robert Edward Caton, M.D.
-
Anika Godhwani, DO
-
Vicki R Gordon, MD PHD
-
Kenichi T Miyata, MD
-
William Louis Pistel, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 921160
- Legal name
- GOLDEN VALLEY HEALTH CENTERS
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- May 7, 2019
- Last certification
- May 7, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 7, 1973 in CA
- Enrollment address
- 302 Northgate Dr
Manteca, CA 95336-3139
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Gurjeet Sandhu |
Corporate Officer |
Jun 23, 2003 | |
| W-2 Managing Employee |
Jun 23, 2003 | ||
| Robert Bernard Anderson |
Corporate Director |
Mar 1, 2016 | |
| David Ray Carr |
Corporate Director |
Sep 8, 2022 | |
| David Quackenbush |
Corporate Officer |
May 1, 2024 | |
| Corporate Director |
May 1, 2024 | ||
| Operational/Managerial Control |
May 1, 2024 | ||
| Keshava David Kamins |
Corporate Director |
Mar 9, 2023 | |
| Tamara Ramaine Cobb |
Corporate Director |
Oct 11, 2018 | |
| Ernesto Martin Gomez |
Corporate Director |
Feb 1, 2016 | |
| Tricia Forshey |
W-2 Managing Employee |
Apr 26, 2021 | |
| Maria Rafela Vargas-Perez |
Corporate Director |
Sep 1, 2012 | |
| John Edward Price |
Corporate Director |
Jul 1, 1986 | |
| Maria Rosales |
Corporate Director |
Aug 13, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040128000641 | CA | Part B Supplier - Clinic/Group Practice | 4183527187 |
Receives reassigned benefits from 494 practitioners 45 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Modesto, CA; Manteca, CA; Newman, CA; Patterson, CA; Planada, CA; Riverbank, CA; Turlock, CA; Westley, CA… |
| O20190508003127 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 4183527187 | Practice locations: Manteca, CA |
National Provider Directory
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
302 Northgate Dr
Manteca, CA 95336-3139
Mailing address
1910 Customer Care Way
Atwater, CA 95301-5167
Phone (209) 722-4842
Other providers in Manteca, CA
- Christine Githaiga
- Lisa Michelle Gitthens Moses
- Nicole Giuliacci
- Joseph Gilbert Giulian
- April Jovita Givens Spiller
- Golden Valley Health Center
- Goldencare Traansportation LLC
- Goldleaf Med Pharmacy LTC LLC
- Katarzyna Magdalena Golebiewska
- Amanda Gomez
All providers in Manteca, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.