Individual provider Active NPI

Olivia Taylor Chan, PA-C

  • Physician Assistant
  • Pleasanton, CA
National Provider Identifier
1407681802
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
67657 Issued in CA
Practice address
5725 W Las Positas Blvd Ste 100a
Pleasanton, CA 94588-4054
Phone
(925) 734-8130
NPI assigned
Sep 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 67657 CA Primary

Addresses

Primary practice location

5725 W Las Positas Blvd Ste 100a
Pleasanton, CA 94588-4054

Mailing address

5725 W Las Positas Blvd Ste 100a
Pleasanton, CA 94588-4054
Phone (925) 734-8130

Other practice location 1

5725 W Las Positas Blvd Ste 100
Pleasanton, CA 94588-4007
Phone (833) 444-7622

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260526000319 CA Practitioner - Physician Assistant 3577033109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 Pasteur Dr
FL 3
Palo Alto, CA 94304-1048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1407681802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 W LAS POSITAS BLVD STE 100A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884054",
            "telephone_number": "925-734-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 W LAS POSITAS BLVD STE 100A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884054",
            "telephone_number": "925-734-8130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5725 W Las Positas Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945884007",
            "country_code": "US",
            "telephone_number": "833-444-7622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "OLIVIA",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "67657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.