MEDICARE: ANASA JAMALA STORAY-DEMBY LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	17569	CA

General Provider Information

NPI Number	:	1821642570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASA JAMALA STORAY-DEMBY LPCC

Provider Business Mailing Address
First Line	:	1650 ADAMS AVE
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4958
Country	:	US
Telephone Number	:	949-734-7432
Fax Number	:

Provider Business Practice Location Address
First Line	:	5025 E PACIFIC COAST HWY APT 240
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3297
Country	:	US
Telephone Number	:	562-350-3512
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2019
Last Update Date	:	09/25/2024

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Directions to “ ANASA JAMALA STORAY-DEMBY LPCC” Practice Location

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