Healthcare Provider Details

I. General information

NPI: 1265358600
Provider Name (Legal Business Name): BREEZE JEFFRIES ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 W LAMBERT RD
LA HABRA CA
90631-6572
US

IV. Provider business mailing address

1503 W LAMBERT RD
LA HABRA CA
90631-6572
US

V. Phone/Fax

Practice location:
  • Phone: 562-265-8065
  • Fax:
Mailing address:
  • Phone: 562-265-8065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113637
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: