Individual ProviderKassandra ChavezSocial WorkerBehavioral Health & Social Service ProvidersPractice Address160 E Virginia St Ste 280, San Jose, CA 95112-5817(408) 938-2113PECOS EnrollmentBased on the most recent information from CMS, provider Kassandra Chavez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1760955165Provider TypeIndividualFull NameChavez, KassandraGenderFemaleSole ProprietorNoEnumeration Date1/8/2019Last Updated7/14/2025Contact InformationPractice LocationPractice Address160 E Virginia St Ste 280, San Jose, CA 95112-5817Phone(408) 938-2113Fax(408) 579-6143Mailing LocationMailing Address160 E Virginia St Ste 280, San Jose, CA 95112-5817PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseASW131765CaliforniaCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer