Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | LMFT109570 | CA |
NPI | 1073088258 |
---|---|
Provider Name | Brandon Keith Hoshiko |
First Address | San Jose, CA 95150-6731 |
Second Address | San Jose, CA 95128-4328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2018 |
Last Update Date | 04/03/2020 |