Healthcare Provider Details
I. General information
NPI: 1750859674
Provider Name (Legal Business Name): JAKE TERESA FERRANTE LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/08/2018
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date: 08/14/2019
Reactivation Date: 04/29/2020
III. Provider practice location address
675 S ARROYO PKWY STE 420
PASADENA CA
91105-3215
US
IV. Provider business mailing address
175 VALLEY ST APT 4100
PASADENA CA
91105-4533
US
V. Phone/Fax
- Phone: 925-282-1778
- Fax:
- Phone: 626-375-1729
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 128809 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LPC-17558 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: