Provider Demographics
NPI:1982466447
Name:WITMER, JAMES CARL II (MSW, ACSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CARL
Last Name:WITMER
Suffix:II
Gender:M
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 S FLOWER ST APT 300
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-2679
Mailing Address - Country:US
Mailing Address - Phone:213-281-0001
Mailing Address - Fax:
Practice Address - Street 1:2315 S FLOWER ST APT 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2679
Practice Address - Country:US
Practice Address - Phone:213-281-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1087261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty