Wesley Wayne Williams

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

112647 Issued in CA

Practice address

15409 Anacapa Rd Ste 409-F
Victorville, CA 92392-2463

Phone

(909) 695-7410

NPI assigned

Mar 27, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Raw Counseling Inc.

  • Clinical Social Worker
  • Victorville, CA
  • NPI 1518780519
  Medicare reassignment NPD Authorized official
• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Bernardino, CA
  • NPI 1164467023
  Medicare reassignment

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1790489763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2622",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923932622",
            "telephone_number": "909-695-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15409 ANACAPA RD STE 409-F",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922463",
            "telephone_number": "909-695-7410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12555 Mariposa Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923956010",
            "country_code": "US",
            "telephone_number": "760-596-0347",
            "fax_number": "760-513-9743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WESLEY",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "112647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Marie Williams
• Serena Williams
• Stephanie Denise Williams
• Tataneisha Williams
• Traci R Williams, PT
• Dashonne Williamsbenjamin
• Dianne Williamson, RPH
• Heaven Willis
• Jahmaal Jason Willis, NP
• Jason A Willridge

• Clinical Social Worker in Victorville, CA
• Providers in Victorville, 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 Mar 24, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.