Provider Demographics
NPI:1073301073
Name:ZIDE, DANIELLE (PPS)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:ZIDE
Suffix:
Gender:
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S MILLS RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3487
Mailing Address - Country:US
Mailing Address - Phone:805-289-7900
Mailing Address - Fax:805-289-7900
Practice Address - Street 1:100 S MILLS RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3487
Practice Address - Country:US
Practice Address - Phone:805-289-7900
Practice Address - Fax:805-289-7900
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool