Individual provider Active NPI

Omar J Breedlove, MSW

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1649860115
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
115 10TH St
San Francisco, CA 94103-2604
Phone
(415) 374-7854
NPI assigned
Jan 19, 2021
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary
Peer Specialist 175T00000X MPSS-EQTMLB CA

Addresses

Primary practice location

115 10TH St
San Francisco, CA 94103-2604

Mailing address

1360 Mission St FL 2
San Francisco, CA 94103-2647
Phone (628) 217-7464

Other practice location 1

555 Stevenson St
San Francisco, CA 94103-1606
Phone (628) 217-5800

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
MPSS-EQTMLBCAMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Area Multi-Services, Inc. PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1649860115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 MISSION ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032647",
            "telephone_number": "628-217-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 10TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032604",
            "telephone_number": "415-374-7854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Stevenson St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941031606",
            "country_code": "US",
            "telephone_number": "628-217-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREEDLOVE",
        "first_name": "OMAR",
        "middle_name": "J",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-19",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-EQTMLB",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.

Verify at the official NPI Registry.