Provider Demographics
NPI:1396891784
Name:GONZALES, LYNN WHITLATCH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:WHITLATCH
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LYNN
Other - Middle Name:MARY- MARJORIE
Other - Last Name:WHITLATCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7898
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7898
Mailing Address - Country:US
Mailing Address - Phone:559-713-1722
Mailing Address - Fax:559-625-1424
Practice Address - Street 1:525 W CENTER AVE STE C
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6045
Practice Address - Country:US
Practice Address - Phone:559-471-8553
Practice Address - Fax:559-625-1424
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS221281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical