Individual provider Active NPI

Clarice P Chan, M.D.

  • Psychiatry Physician
  • Yorba Linda, CA
National Provider Identifier
1073856084
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A140711 Issued in CA
Practice address
18543 Yorba Linda Blvd # 395
Yorba Linda, CA 92886-4135
Phone
(657) 337-0010
NPI assigned
Mar 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A140711 CA
Psychiatry Physician 2084P0800X A140711 CA Primary

Addresses

Primary practice location

18543 Yorba Linda Blvd # 395
Yorba Linda, CA 92886-4135

Mailing address

18543 Yorba Linda Blvd # 395
Yorba Linda, CA 92886-4135
Phone (904) 242-6638

Other practice location 1

3545 Long Beach Blvd
Long Beach, CA 90807-3941
Phone (562) 490-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190725003585 CA Practitioner - Psychiatry 8325374564 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A140711CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Jun 2, 2019 Accepting new patients
Pih Health Physicians CurrentSince Apr 18, 2021 Accepting new patients
Pih Health Physicians Current Accepting new patients
County of Santa Cruz CurrentSince Aug 1, 2024 Accepting new patients
County of Santa Cruz CurrentSince Aug 1, 2024 Accepting new patients
Department of State Hospitals CurrentSince Jun 2, 2019 Accepting new patients
Pih Health Physicians CurrentSince Apr 18, 2021 Accepting new patients
County of Butte CurrentSince May 1, 2022 Accepting new patients
County of Butte CurrentSince May 1, 2022 Accepting new patients
County of Butte Current Accepting new patients
Childnet Youth and Family Services Inc PastSince Jan 8, 2023 Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

109 Parmac Rd
Ste 2
Chico, CA 95926
Phone (530) 879-3363

3217 Cohasset Rd
Cohasset, CA 95973
Phone (530) 552-4578

995 Spruce St
Gridley, CA 95948
Phone (530) 846-7305

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

1400 Emeline Ave
Bldg K
Santa Cruz, CA 95060
Phone (831) 454-4900

1400 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4900

1430 Freedom Blvd
Watsonville, CA 95076
Phone (831) 763-8200

Organizations & group practices 11

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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1073856084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18543 YORBA LINDA BLVD # 395",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864135",
            "telephone_number": "904-242-6638",
            "fax_number": "559-935-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18543 YORBA LINDA BLVD # 395",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864135",
            "telephone_number": "657-337-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3545 Long Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908073941",
            "country_code": "US",
            "telephone_number": "562-490-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CLARICE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A140711",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A140711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

Verify at the official NPI Registry.