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NPI Code Detail

MEDICARE: JAKE ALANO

MEDICARE: JAKE ALANO
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
1103TB0200XCognitive & Behavioral Psychologist
2390200000XStudent in an Organized Health Care Education/Training ProgramCA
3225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1083274526
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAKE ALANO
Provider Business Mailing Address
First Line : 1279 W 32ND ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90810-2508
Country : US
Telephone Number : 562-522-7675
Fax Number :
Provider Business Practice Location Address
First Line : 21535 HAWTHORNE BLVD STE 102
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6626
Country : US
Telephone Number : 310-817-2177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2019
Last Update Date : 04/21/2026

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