Active NPI
Andrew Breedlove
- Clinical Social Worker
- Rocklin, CA
National Provider Identifier
1629089586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 27174
- Practice address
- 5215 Whitney Blvd
Rocklin, CA 95677-2252 - Phone
- (916) 622-6579
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 27174 | CA | Primary |
Addresses
Primary practice location
5215 Whitney Blvd
Rocklin, CA 95677-2252
Mailing address
5215 Whitney Blvd
Rocklin, CA 95677-2252
Phone (916) 622-6579
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27174 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739145600000",
"number": "1629089586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5215 WHITNEY BLVD",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "956772252",
"telephone_number": "916-622-6579",
"fax_number": "916-632-8613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5215 WHITNEY BLVD",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "956772252",
"telephone_number": "916-622-6579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREEDLOVE",
"first_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2025-02-10",
"certification_date": "2025-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "27174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocklin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.