Healthcare Provider Details

I. General information

NPI: 1114731627
Provider Name (Legal Business Name): COURTNEY MARIE DYER CNM/WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W AVENUE J
LANCASTER CA
93534-2814
US

IV. Provider business mailing address

32510 FALLVIEW RD
WESTLAKE VILLAGE CA
91361-5535
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-5000
  • Fax:
Mailing address:
  • Phone: 818-519-1976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number95032038
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236518
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: