Individual provider · NPI-1

Omar J Breedlove, MSW

Social Worker, Clinical · San Francisco, CA

NPI number1649860115
StatusActive
Last updated in NPPESAug 25, 2025

Details

NPI
1649860115
Entity type
Individual (NPI-1)
Name
Omar J Breedlove
Credential
MSW
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 19, 2021
Certification date
Aug 25, 2025
Last updated
Aug 25, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical––Yes
175T00000X Peer SpecialistMPSS-EQTMLBCA

Practice location

115 10th St
San Francisco, CA 94103-2604

Phone 415-374-7854

Mailing address

1360 Mission St Fl 2
San Francisco, CA 94103-2647

Phone 628-217-7464

Other practice locations

555 Stevenson St
San Francisco, CA 94103-1606

Phone 628-217-5800

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