Individual provider Active NPI

Benjamin Chang

  • Psychiatry Physician
  • Fontana, CA
National Provider Identifier
1184251365
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A177776 Issued in CA
Practice address
17234 Valley Blvd., BLDG. a
Fontana, CA 92335
Phone
(866) 205-3595
NPI assigned
Mar 26, 2020
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A177776 CA Primary

Addresses

Primary practice location

17234 Valley Blvd., BLDG. a
Fontana, CA 92335

Mailing address

2501 E Chapman Ave Ste 265
Fullerton, CA 92831-3108
Phone (714) 706-0206

Other practice location 1

2501 E Chapman Ave Ste 265
Fullerton, CA 92831-3108
Phone (714) 706-0206

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
I20230821001827 CA Practitioner - Psychiatry 2668853672 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jul 9, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 9, 2023 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1184251365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 265",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313108",
            "telephone_number": "714-706-0206",
            "fax_number": "714-706-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17234 VALLEY BLVD., BLDG. A",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "866-205-3595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 E Chapman Ave Ste 265",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928313108",
            "country_code": "US",
            "telephone_number": "714-706-0206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A177776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.