Provider Demographics
NPI:1073088258
Name:HOSHIKO, BRANDON KEITH (LMFT)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:KEITH
Last Name:HOSHIKO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6731
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95150-6731
Mailing Address - Country:US
Mailing Address - Phone:408-909-3551
Mailing Address - Fax:
Practice Address - Street 1:1361 S WINCHESTER BLVD STE 208
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4328
Practice Address - Country:US
Practice Address - Phone:408-909-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT109570103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty