Individual provider Active NPI

Danette Elaine Wilkerson, MA, NCC

  • Mental Health Counselor
  • Pasadena, CA
National Provider Identifier
1003617168
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17463 Issued in CA
Practice address
595 E Colorado Blvd Ste 635
Pasadena, CA 91101-2032
Phone
(310) 895-5692
NPI assigned
Mar 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 17463 CA Primary

Addresses

Primary practice location

595 E Colorado Blvd Ste 635
Pasadena, CA 91101-2032

Mailing address

595 E Colorado Blvd Ste 635
Pasadena, CA 91101-2032
Phone (310) 895-5692

Other practice location 1

1711 Lordsburg Ct
LA Verne, CA 91750-5682
Phone (310) 895-5692

Other names 1

  • Dannete Elaine Wilkerson Other name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
17463CAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1003617168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD STE 635",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012032",
            "telephone_number": "310-895-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD STE 635",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012032",
            "telephone_number": "310-895-5692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1711 Lordsburg Ct",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "917505682",
            "country_code": "US",
            "telephone_number": "310-895-5692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "DANETTE",
        "middle_name": "ELAINE",
        "credential": "MA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "17463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANNETE",
            "last_name": "WILKERSON",
            "middle_name": "ELAINE",
            "credential": "MA, NCC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.