Healthcare Provider Details

I. General information

NPI: 1609330299
Provider Name (Legal Business Name): ORLANDO INTERIANO LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 GILLETTE CRST
SOUTH PASADENA CA
91030-4322
US

IV. Provider business mailing address

PO BOX 62914
LOS ANGELES CA
90062-0914
US

V. Phone/Fax

Practice location:
  • Phone: 626-372-3141
  • Fax:
Mailing address:
  • Phone: 626-372-3141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number144147
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: