Vanessa Fraga Degollado

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

84723 Issued in TX

Practice address

1111 Highway 6 Ste 120
Sugar Land, TX 77478-4900

Phone

(281) 769-2238

Fax

(281) 769-2164

NPI assigned

Apr 23, 2019

Reactivated

Aug 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1396309654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 HIGHWAY 6 STE 120",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784900",
            "telephone_number": "281-769-2238",
            "fax_number": "281-769-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HIGHWAY 6 STE 120",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784900",
            "telephone_number": "281-769-2238",
            "fax_number": "281-769-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGOLLADO",
        "first_name": "VANESSA",
        "middle_name": "FRAGA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "deactivation_date": "2022-08-01",
        "reactivation_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "84723",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "84723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373188702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ray John De Leon
• Sonia Euncie De Silva, MS CCC-SLP
• Stephen De Young, M.D.
• Deena Gandhi MD PA
• Danielle Degollado
• Tracie Michele Dejarnette-Holly, MD
• Maria M Del Pilar, P.T.
• Emily Del Rosario
• John Brian Dela Cruz
• Tammy Rane' Delagarza, FNP-C

• Professional Counselor in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.