Provider Demographics
NPI:1609883826
Name:GOGGIN, WILLIAM ANTHONY (LCSW LMFT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:GOGGIN
Suffix:
Gender:M
Credentials:LCSW LMFT
Other - Prefix:
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Mailing Address - Street 1:731 E YOSEMITE AVE
Mailing Address - Street 2:STE B BOX 142
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8039
Mailing Address - Country:US
Mailing Address - Phone:209-383-0391
Mailing Address - Fax:209-383-4830
Practice Address - Street 1:1160 OLIVEWOOD DR
Practice Address - Street 2:STE A9
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340
Practice Address - Country:US
Practice Address - Phone:209-383-0391
Practice Address - Fax:209-383-4830
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CALCS3518106H00000X, 1041C0700X
CAMFC4315106H00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ77421ZMedicare ID - Type Unspecified