NPIMap

Organization Active NPI

Banyan Psychology Inc.

Doing business as Banyan Behavioral Health

  • Clinical Psychologist
  • Burlingame, CA
National Provider Identifier
1386336501
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
BANYAN PSYCHOLOGY INC.
Doing business as
Banyan Behavioral Health
Practice address
877 Mahler Rd Ste 160
Burlingame, CA 94010-1640
Phone
(650) 822-1057
Fax
(650) 563-5570
NPI assigned
May 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
William Chan, PSY.D.NPI 1376033084
Title
President
Phone
(650) 667-7193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

877 Mahler Rd Ste 160
Burlingame, CA 94010-1640

Mailing address

877 Mahler Rd Ste 160
Burlingame, CA 94010-1640
Phone (650) 822-1057

Other practice location 1

100 S Ellsworth Ave Ste 802
San Mateo, CA 94401-3926
Phone (650) 667-7193

Other names 1

  • Banyan Behavioral Health Doing business as

National Provider Directory

National Provider Directory

Locations

877 Mahler Rd
Ste 160
Burlingame, CA 94010
Phone (650) 822-1057

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1386336501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 MAHLER RD STE 160",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940101640",
            "telephone_number": "650-822-1057",
            "fax_number": "650-563-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 MAHLER RD STE 160",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940101640",
            "telephone_number": "650-822-1057",
            "fax_number": "650-563-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S Ellsworth Ave Ste 802",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944013926",
            "country_code": "US",
            "telephone_number": "650-667-7193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BANYAN PSYCHOLOGY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-667-7193",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banyan Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.