Dr. Maryellen Dyer-Russell, DNP, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Oxnard, CA. Individual provider (NPI-1).
NPI number1174652002
StatusActive
Last updated in NPPESJul 2, 2021
Details
- NPI
- 1174652002
- Entity type
- Individual (NPI-1)
- Name
- Dr. Maryellen Dyer-Russell
- Credential
- DNP, PMHNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 5, 2007
- Certification date
- Jun 18, 2021
- Last updated
- Jul 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 9664 | CA | Yes |
| 363LP0200X | Nurse Practitioner, Pediatrics | B333567-9664 | CA |
Practice location
1911 Williams DrOxnard, CA 93036-2612
Phone 805-981-6830 · Fax 805-289-3395
Mailing address
800 S Victoria Ave, L4615Vchca - Physician Services
Ventura, CA 93009-0003
Phone 805-677-5181 · Fax 805-677-5304
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All 7 Psychiatric/Mental Health Nurse Practitioner providers in Oxnard · All 4,006 providers in Oxnard
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