Golden Valley Health Center

Organization Active NPI Federally Qualified Health Center (FQHC) · Modesto, CA

NPI 1508464116 · NPPES record last updated Feb 27, 2026

Key facts

NPI
1508464116
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
GOLDEN VALLEY HEALTH CENTER
Practice address
1524 McHenry Ave Ste 560
Modesto, CA 95350-4573
Phone
(866) 682-4842
NPI assigned
Oct 15, 2020
Organization subpart
No

Authorized official

Name
David Quackenbush
Title
Ceo and President
Phone
(209) 913-2261

Other NPIs on the same Medicare enrollment 45

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 45

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

Federally qualified health center certification: CCN A01025

Legal name
GOLDEN VALLEY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 22, 2021
Last certification
Sep 22, 2021
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Nov 14, 1972 in CA
Enrollment address
1524 McHenry Ave
Ste 560
Modesto, CA 95350-4573

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gurjeet Sandhu
Individual
Corporate Officer
VP and Chief Financial Officer
Jun 23, 2003
W-2 Managing Employee
VP and Chief Financial Officer
Jun 23, 2003
Robert Bernard Anderson
Individual
Corporate Director
Board Member
Mar 1, 2016
David Ray Carr
Individual
Corporate Director
Board Member
Sep 8, 2022
David Quackenbush
Individual
Corporate Officer
President and Ceo
May 1, 2024
Corporate Director
President and Ceo
May 1, 2024
Operational/Managerial Control
President and Ceo
May 1, 2024
Keshava David Kamins
Individual
Corporate Director
Board Member
Mar 9, 2023
Tamara Ramaine Cobb
Individual
Corporate Director
Board Member
Oct 11, 2018
Ernesto Martin Gomez
Individual
Corporate Director
Board Member
Feb 1, 2016
Tricia Forshey
Individual
W-2 Managing Employee
Senior Credentialing Specialist
Apr 26, 2021
Maria Rafela Vargas-Perez
Individual
Corporate Director
Board Member
Sep 1, 2012
John Edward Price
Individual
Corporate Director
Board Member
Jul 1, 1986
Maria Rosales
Individual
Corporate Director
Board Member
Aug 13, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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…
O20210428000143 CA Part a Provider - Federally Qualified Health Center (FQHC) 4183527187 Practice locations: Modesto, CA

National Provider Directory

Tax ID family
Golden Valley HLTH CT (96 organizations share this tax ID)

Locations

3940 Sandpiper Ave
Merced, CA 95340
Phone (209) 381-4104

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

1524 McHenry Ave Ste 560
Modesto, CA 95350-4573

Mailing address

1910 Customer Care Way
Atwater, CA 95301-5167
Phone (209) 722-4842

Other providers in Modesto, CA

All providers in Modesto, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.