NPIMap

Individual provider Active NPI

Grant Michael Patterson, SUDRC

  • Addiction (Substance Use Disorder) Counselor
  • Escondido, CA
National Provider Identifier
1649780230
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
21935 Issued in CA
Practice address
504 W Mission Ave Ste 106
Escondido, CA 92025-1603
Phone
(619) 281-3706
Fax
(760) 796-4387
NPI assigned
Oct 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X
Social Worker 104100000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 21935 CA Primary
Case Manager/Care Coordinator 171M00000X CA

Addresses

Primary practice location

504 W Mission Ave Ste 106
Escondido, CA 92025-1603

Mailing address

8787 Complex Dr Ste 300
San Diego, CA 92123-1453
Phone (619) 797-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21935CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fred Finch Youth Center CurrentSince Apr 10, 2022 Accepting new patients
Fred Finch Youth Center Cares Social Worker CurrentSince Aug 7, 2022 Accepting new patients
Fred Finch Youth Center Mental Health PastSince Apr 10, 2022 Accepting new patients
Fred Finch Youth Center PastSince Apr 10, 2022 Accepting new patients

Locations

8787 Complex Dr
Ste 300
San Diego, CA 92123
Phone (619) 797-1090

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1649780230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8787 COMPLEX DR STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231453",
            "telephone_number": "619-797-1090",
            "fax_number": "760-796-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W MISSION AVE STE 106",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920251603",
            "telephone_number": "619-281-3706",
            "fax_number": "760-796-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "GRANT",
        "middle_name": "MICHAEL",
        "credential": "SUDRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-09",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "21935",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.