Healthcare Provider Details

I. General information

NPI: 1063180867
Provider Name (Legal Business Name): ALANA SMITH-GROVE AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2021
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 ESPARTO AVE
PISMO BEACH CA
93449-1915
US

IV. Provider business mailing address

150 ESPARTO AVE
PISMO BEACH CA
93449-1915
US

V. Phone/Fax

Practice location:
  • Phone: 415-326-6354
  • Fax:
Mailing address:
  • Phone: 415-326-3646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: