Healthcare Provider Details

I. General information

NPI: 1083274526
Provider Name (Legal Business Name): JAKE ALANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21535 HAWTHORNE BLVD STE 102
TORRANCE CA
90503-6626
US

IV. Provider business mailing address

1279 W 32ND ST
LONG BEACH CA
90810-2508
US

V. Phone/Fax

Practice location:
  • Phone: 310-817-2177
  • Fax:
Mailing address:
  • Phone: 562-522-7675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT163823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: