Individual provider Active NPI

Theresa M Hozian, PSYD.

  • Clinical Psychologist
  • Sebastopol, CA
National Provider Identifier
1932583614
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSB94021621 Issued in CA
Practice address
7765 Healdsburg Ave
Suite 17
Sebastopol, CA 95472-3309
Phone
(415) 994-0047
NPI assigned
Jul 13, 2015
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSB94021621 CA Primary

Addresses

Primary practice location

7765 Healdsburg Ave
Suite 17
Sebastopol, CA 95472-3309

Mailing address

7765 Healdsburg Ave
Suite 17
Sebastopol, CA 95472-3309
Phone (415) 994-0047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSB94021621CAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1932583614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7765 HEALDSBURG AVE",
            "address_2": "SUITE 17",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723309",
            "telephone_number": "415-994-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7765 HEALDSBURG AVE",
            "address_2": "SUITE 17",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723309",
            "telephone_number": "415-994-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOZIAN",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94021621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.