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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

CHARLES GREEN
NPI 1003734153
Counselor - Addiction (Substance Use Disorder) in San Diego, CA

Active since July 07, 2026
4017 42ND ST, SAN DIEGO, CA 92105(619) 236-9492 Get Directions Write a Review

NPPES record added: July 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Charles Green NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES GREEN (NPI 1003734153) is an individual addiction (substance use disorder) provider in San Diego, California, licensed in California (20279) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1003734153
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameCHARLES GREEN
Location Address4017 42ND STSan Diego, CA 92105-1506
Mailing Address1919 Ensenada StLemon Grove, CA 91945-3739
Phone(619) 236-9492
Sole ProprietorYes
Enumeration DateJuly 7, 2026
NPPES CertifiedJuly 7, 2026
✔ NPI 1003734153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · 20279
4017 42ND ST, San Diego, CA 92105
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DARIN GRANT JAMES CADC 1
Counselor (Addiction (Substance Use Disorder))
4017 42ND ST
SAN DIEGO, CA 92105
San Diego County (619) 236-9217

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Green's NPI number?

The NPI number for Charles Green is 1003734153. It was assigned to this individual provider in the NPPES registry on July 7, 2026.

Where is Charles Green located?

Charles Green practices at 4017 42nd St, San Diego, CA 92105. The listed phone number is (619) 236-9492.

What is Charles Green's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Charles Green was last updated on July 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.