MEDICARE: CASSIDY HOZER

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker	ASW129721	CA

General Provider Information

NPI Number	:	1558195313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSIDY HOZER

Provider Business Mailing Address
First Line	:	7280 BLUE HILL DR STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-3624
Country	:	US
Telephone Number	:	866-679-9855
Fax Number	:

Provider Business Practice Location Address
First Line	:	7280 BLUE HILL DR STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-3624
Country	:	US
Telephone Number	:	866-679-9855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/06/2025

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Directions to “ CASSIDY HOZER ” Practice Location

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