Evelyn Rovida Fragoso Wilkerson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

480015BP Issued in CA

Practice address

352 Adobe Dr
Vacaville, CA 95687

Phone

(707) 365-2251

NPI assigned

Dec 12, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1508001967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 ADOBE DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875805",
            "telephone_number": "707-365-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 ADOBE DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-365-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGOSO WILKERSON",
        "first_name": "EVELYN",
        "middle_name": "ROVIDA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "480015BP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "4821",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Analyssa Breanne Porquez Fontaine
• William Clay Foreman, PH.D.
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• Farin Foroudi
• David Fountain, RRT
• Israel Francisco
• Sharon Frank
• Tracy M Frank, MS CCC-SLP
• Brenda Frechette, PHD
• Freedom Family Counseling Group Corp. (Freedom Counseling Group)

• Addiction (Substance Use Disorder) Counselor in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.