Individual provider Active NPI

Bryson Greaves, PHD, LMFT

  • Marriage & Family Therapist
  • La Jolla, CA
National Provider Identifier
1740709799
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT98263 Issued in CA
Practice address
7946 Ivanhoe Ave Ste 203
La Jolla, CA 92037-4517
Phone
(619) 417-5166
NPI assigned
Sep 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT98263 CA Primary

Addresses

Primary practice location

7946 Ivanhoe Ave Ste 203
La Jolla, CA 92037-4517

Mailing address

4025 Gresham St Unit 4
San Diego, CA 92109-5865
Phone (619) 417-5166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 30, 2025 through Jan 30, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
98263CAMDClinical Social Worker
LMFT98263CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1740709799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 GRESHAM ST UNIT 4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095865",
            "telephone_number": "619-417-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7946 IVANHOE AVE STE 203",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374517",
            "telephone_number": "619-417-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREAVES",
        "first_name": "BRYSON",
        "name_prefix": "Dr.",
        "credential": "PHD, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT98263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.