Healthcare Provider Details

I. General information

NPI: 1306327598
Provider Name (Legal Business Name): CASSANDRA ADRIENNE HAZEN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3852 PIEDMONT AVE # 206
OAKLAND CA
94611-5353
US

IV. Provider business mailing address

608 ELSIE AVE
SAN LEANDRO CA
94577-5212
US

V. Phone/Fax

Practice location:
  • Phone: 510-470-1103
  • Fax:
Mailing address:
  • Phone: 510-520-1508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number107285
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number107285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: