Provider Demographics
NPI:1982255568
Name:ANORAJ, JESSE C (CMT, NMT)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:C
Last Name:ANORAJ
Suffix:
Gender:M
Credentials:CMT, NMT
Other - Prefix:MR
Other - First Name:CHETSADA
Other - Middle Name:
Other - Last Name:ANORAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMT
Mailing Address - Street 1:8000 SUNSET BLVD
Mailing Address - Street 2:#B200-16
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-2439
Mailing Address - Country:US
Mailing Address - Phone:424-666-7026
Mailing Address - Fax:
Practice Address - Street 1:8000 SUNSET BLVD
Practice Address - Street 2:#B200-16
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-2439
Practice Address - Country:US
Practice Address - Phone:424-666-7026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77236225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist