Healthcare Provider Details

I. General information

NPI: 1104737824
Provider Name (Legal Business Name): THEA LAMAY M.A., AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 VENTURE STE 340
IRVINE CA
92618-7330
US

IV. Provider business mailing address

1508 BUENA VIS APT B
SAN CLEMENTE CA
92672-4984
US

V. Phone/Fax

Practice location:
  • Phone: 949-750-4777
  • Fax:
Mailing address:
  • Phone: 949-449-7006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number164338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: