Provider Demographics
NPI:1083500359
Name:HAGLE, JEFFREY (ACSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:HAGLE
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5942 EDINGER AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-1773
Mailing Address - Country:US
Mailing Address - Phone:714-943-6922
Mailing Address - Fax:
Practice Address - Street 1:7755 CENTER AVE STE 1100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3091
Practice Address - Country:US
Practice Address - Phone:949-734-0746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAACSW11452104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker