Healthcare Provider Details

I. General information

NPI: 1013766187
Provider Name (Legal Business Name): JENNIFER BRESLIN PHD, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5243
SHERMAN OAKS CA
91413-5243
US

IV. Provider business mailing address

PO BOX 5243
SHERMAN OAKS CA
91413-5243
US

V. Phone/Fax

Practice location:
  • Phone: 415-449-2813
  • Fax:
Mailing address:
  • Phone: 323-380-0909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC12717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: