Healthcare Provider Details

I. General information

NPI: 1386239895
Provider Name (Legal Business Name): DANIELLE KAYLENE ZITEK PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S ALMA SCHOOL RD STE 204
CHANDLER AZ
85248-3773
US

IV. Provider business mailing address

3200 S ALMA SCHOOL RD STE 204
CHANDLER AZ
85248-3773
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-5500
  • Fax:
Mailing address:
  • Phone: 480-728-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number8635
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8635
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: