Ilene Chang, PMHNP - BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95033809 Issued in CA

Practice address

901 E Alosta Ave
Azusa, CA 91702-2701

Phone

(714) 401-2471

NPI assigned

Aug 9, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Vortex Mental Health

  • Psychiatry Physician
  • Long Beach, CA
  • NPI 1841834694
  Medicare reassignment

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

{
    "created_epoch": "1754697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1316822273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E ALOSTA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E ALOSTA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022701",
            "telephone_number": "714-401-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ILENE",
        "credential": "PMHNP - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-09",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95033809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Integrated Family and Health Services
• Nora Guzman Cepeda
• Diana Cervantes
• Ronald Joseph Cervantes, PT
• Chances 4 Change, Inc.
• Silfia Chatibus Satari, BA
• ER Shao Chau
• Heathyr Nicole Chavarin, RN BSN
• John Chavez
• Michael Anthony Chavez, APCC, PPSC

• Psychiatric/Mental Health Nurse Practitioner in Azusa, CA
• Providers in Azusa, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.