MEDICARE: CASSANDRA ADRIENNE HAZEN LMFT

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	101YM0800X	Mental Health Counselor	107285	CA
2	106H00000X	Marriage & Family Therapist	107285	CA

General Provider Information

NPI Number	:	1306327598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA ADRIENNE HAZEN LMFT

Provider Business Mailing Address
First Line	:	608 ELSIE AVE
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-5212
Country	:	US
Telephone Number	:	510-520-1508
Fax Number	:

Provider Business Practice Location Address
First Line	:	3852 PIEDMONT AVE # 206
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-5353
Country	:	US
Telephone Number	:	510-470-1103
Fax Number	:

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

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	05/06/2026

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