George Christopher Graveline, CADC II #A062350323

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A062350323 Issued in CA

Practice address

641 Broadway St
King City, CA 93930-3231

Phone

(813) 525-8181

Fax

(831) 525-8130

NPI assigned

Jan 5, 2016

Last updated

Mar 23, 2023By the provider in NPPES

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

Practice roles

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.

• Pathway Society Inc

  • Substance Abuse Rehabilitation Facility
  • San Jose, CA
  • NPI 1902194095
  NPD (past)
• Sun Street Centers

  • Substance Abuse Rehabilitation Facility
  • King City, CA
  • NPI 1265923437
  NPD (past)

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1376909432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 BROADWAY ST",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939303231",
            "telephone_number": "813-525-8181",
            "fax_number": "831-525-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 BROADWAY ST",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939303231",
            "telephone_number": "813-525-8181",
            "fax_number": "831-525-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELINE",
        "first_name": "GEORGE",
        "middle_name": "CHRISTOPHER",
        "credential": "CADC II  #A062350323",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A062350323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruby Godoy, PHARMACY TECH
• Carina Gonzales
• Irma Gonzalez Cisneros
• Juan M Gonzalez, MD
• Blanca Grado
• Bruce Greenberg, M.D.
• Juan Carlos Guereca Romero, DDS
• Carla G Guzman
• Anthony Halcon, LMFT
• Hamlet Karapetian DMD Inc. (Friendly Smiles Dental Group)

• Addiction (Substance Use Disorder) Counselor in King City, CA
• Providers in King City, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.