Provider Demographics
NPI:1740712926
Name:STANSBERRY, SITUMBA YUMANDA
Entity type:Individual
Prefix:
First Name:SITUMBA
Middle Name:YUMANDA
Last Name:STANSBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4771 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-3250
Mailing Address - Country:US
Mailing Address - Phone:323-233-3342
Mailing Address - Fax:323-233-3183
Practice Address - Street 1:351 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-1402
Practice Address - Country:US
Practice Address - Phone:562-435-7350
Practice Address - Fax:562-432-4532
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)