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Organization
WHOLLY INTEGRATED MENTAL HEALTH FOR CHILDREN,ADOLESCENTS&YOUNG ADULTS
Active
Organization
WHOLLY INTEGRATED MENTAL HEALTH FOR CHILDREN,ADOLESCENTS&YOUNG ADULTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYELLEN DYER-RUSSELL DNP; PMHNP (OWNER OF NURSING CORPORTATION)
(805) 798-4108
Entity
Organization
Contact information
Practice address
107 FIGUEROA ST STE 5, VENTURA, CA 93001-2756
(818) 746-8458
Mailing address
6818 GLADE AVE, CANOGA PARK, CA 91303-2318
(805) 798-4108
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2026
Last updated
08/09/2026
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