Healthcare Provider Details

I. General information

NPI: 1841827557
Provider Name (Legal Business Name): DANIELLE DEHERRERA MA, LMFT #152234
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W STANLEY AVE
VENTURA CA
93001-1313
US

IV. Provider business mailing address

255 W STANLEY AVE
VENTURA CA
93001-1313
US

V. Phone/Fax

Practice location:
  • Phone: 805-641-5000
  • Fax:
Mailing address:
  • Phone: 805-641-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT152234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: