Active NPI
Vanessa V Wilson
- Mental Health Counselor
- Soquel, CA
National Provider Identifier
1073953220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 5905 Soquel Dr
Soquel, CA 95073-2855 - Phone
- (831) 428-5426
- NPI assigned
- Jul 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
5905 Soquel Dr
Soquel, CA 95073-2855
Mailing address
3645 Gatewood CT
Santa Cruz, CA 95065-1666
Phone (831) 428-5426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 21, 2025 through Oct 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1073953220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3645 GATEWOOD CT",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651666",
"telephone_number": "831-428-5426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 SOQUEL DR",
"city": "SOQUEL",
"state": "CA",
"postal_code": "950732855",
"telephone_number": "831-428-5426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "VANESSA",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-02",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Soquel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.