Holly Ruth Goetz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

99336 Issued in CA

Practice address

5176 Hill Rd E
Lakeport, CA 95453-6357

Phone

(707) 262-5000

Fax

(707) 263-2925

NPI assigned

Sep 14, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Holly Ruth Lavine Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1124798830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 COMPTON ST",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534421",
            "telephone_number": "530-228-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536357",
            "telephone_number": "707-262-5000",
            "fax_number": "707-263-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZ",
        "first_name": "HOLLY",
        "middle_name": "RUTH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "99336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "goetzhr@sutterhealth.org",
            "affiliation": "Y",
            "endpointDescription": "Sutter Health assigned email address",
            "affiliationName": "Sutter Bay Hospitals",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EPIC",
            "address_1": "5176 Hill Rd E",
            "city": "Lakeport",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954536357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "LAVINE",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew J. Garrean, P.T.
• Allison Gatton
• Chelsie Toni Buenviaje Gho, NP
• Milcah Wanjiku Gichuru, FNP-BC
• Anju Goel, MD, MPH
• Sarah Gomora
• Veronica Alicia Gonzalez, RDHAP
• Christine Anne Goold, FNP/PA-C
• Kathryn Graham, AOD COUNSELOR
• Thomas Graves

• Clinical Social Worker in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.