Sally Kenton Witmer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

124660 Issued in CA

Practice address

VMR Therapy
5012 Central Ave, Suite F
Bonita, CA 91902

Phone

(619) 636-0909

Fax

(619) 500-5834

NPI assigned

Jun 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sally Elizabeth Kenton Witmer Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment Care Compare group NPD
• VMR Therapy, Inc.

  • Counseling Psychologist
  • Bonita, CA
  • NPI 1235701780
  NPD

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1093550865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8697 LA MESA BLVD STE C",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919429565",
            "telephone_number": "408-221-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VMR THERAPY",
            "address_2": "5012 CENTRAL AVE, SUITE F",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "91902",
            "telephone_number": "619-636-0909",
            "fax_number": "619-500-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMER",
        "first_name": "SALLY",
        "middle_name": "KENTON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "124660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "WITMER",
            "middle_name": "ELIZABETH KENTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vintage Home & Residential Care Inc
• VMR Therapy, Inc.
• William F. Fischer DMD Inc
• Elizabeth Anne Williams, PSYCHOLOGIST
• Susan Wise
• Duncan Jay Woo

• Clinical Social Worker in Bonita, CA
• Providers in Bonita, 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 Aug 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.