Healthcare Provider Details

I. General information

NPI: 1538091665
Provider Name (Legal Business Name): VANESSA TREJO M. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 BIRDCREEK DR STE 100
TEMPLE TX
76502-1020
US

IV. Provider business mailing address

5100 WALTZ CT
KILLEEN TX
76542-4639
US

V. Phone/Fax

Practice location:
  • Phone: 254-598-2266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number101952
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: