Provider Demographics
NPI:1770896706
Name:STUBBS-GOETHE, TONNETTE D (LCSW)
Entity type:Individual
Prefix:MS
First Name:TONNETTE
Middle Name:D
Last Name:STUBBS-GOETHE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TONNETTE
Other - Middle Name:D
Other - Last Name:STUBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 2284
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-2284
Mailing Address - Country:US
Mailing Address - Phone:661-435-9961
Mailing Address - Fax:661-945-5881
Practice Address - Street 1:44750 60TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-7619
Practice Address - Country:US
Practice Address - Phone:661-729-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS236701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical