MEDICARE: VANESSA ULIBAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	21607	CA
2	101Y00000X	Counselor	21607	CA

General Provider Information

NPI Number	:	1528847969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA ULIBAS

Provider Business Mailing Address
First Line	:	8822 KESTREL CT
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1255
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8822 KESTREL CT
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1255
Country	:	US
Telephone Number	:	916-398-0367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2023
Last Update Date	:	12/17/2025

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Directions to “ VANESSA ULIBAS ” Practice Location

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