Individual provider Active NPI

Lauren Witmer, PT

  • Pediatric Physical Therapist
  • Cypress, CA
National Provider Identifier
1508471715
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
299454 Issued in CA
Practice address
11205 Knott Ave Ste E
Cypress, CA 90630-5489
Phone
(714) 893-7399
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 299454 CA Primary

Addresses

Primary practice location

11205 Knott Ave Ste E
Cypress, CA 90630-5489

Mailing address

23511 Aliso Creek Rd Apt 173
Aliso Viejo, CA 92656-1339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
299454CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Pediatric Physical Therapy, Inc Pediatrics CurrentSince Oct 12, 2025 Accepting new patients

Locations

11205 Knott Ave
Ste E
Cypress, CA 90630
Phone (714) 893-7399

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1508471715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23511 ALISO CREEK RD APT 173",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11205 KNOTT AVE STE E",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305489",
            "telephone_number": "714-893-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMER",
        "first_name": "LAUREN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "299454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.