Charles Steven Greaves, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000041042 Issued in TX

Practice address

901 E Alosta Ave
Azusa, CA 91702-2701

Phone

(626) 815-6000

Fax

(626) 815-5442

NPI assigned

Jan 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1114679867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 MARSHBURN AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910065962",
            "telephone_number": "626-482-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E ALOSTA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022701",
            "telephone_number": "626-815-6000",
            "fax_number": "626-815-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREAVES",
        "first_name": "CHARLES",
        "middle_name": "STEVEN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "2000041042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Benedict Gonzalez
• Linda X Gonzalez, M.A.
• Lorena Gonzalez, BCBA
• Mercedes Guadalupe Gonzalez, LMFT
• Eileen Gossett
• Parminder Kaur Grewal
• Andrew Jose Guerra
• Robert Austin Guerrero
• Jocabed Gurrola, MS, BCBA
• Patricia Antoinette Guzman, BS

• Athletic Trainer in Azusa, CA
• Providers in Azusa, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.