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General NPI Number Information
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NPI Number | 1265956395
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Entity Type | Individual
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Provider Name | WILLIAM CLIFTON MCGOWAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15428 CIVIC DR STE 200
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City | VICTORVILLE
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State | CA
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Zip | 92392-2383
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Country | US
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Telephone | 442-255-4722
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Fax | 442-255-4724
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Provider Business Mailing Address
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Address Line | 15428 CIVIC DR STE 200
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City | VICTORVILLE
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State | CA
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Zip | 92392-2383
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Country | US
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Telephone | 442-255-4722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS11657
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License Number State | CA
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