Active NPI
Austin Jeffrey Chandler
- Psychiatric/Mental Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1417839077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95036803
- Practice address
- 11150 W Olympic Blvd Ste 780
Los Angeles, CA 90064-1829 - Phone
- (951) 990-6516
- NPI assigned
- Jul 24, 2025
- Last updated
- Oct 21, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95036803 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 332811 | AZ | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95036803 | CA | Primary |
| Registered Nurse | 163W00000X | 95026834 | CA |
Addresses
Primary practice location
11150 W Olympic Blvd Ste 780
Los Angeles, CA 90064-1829
Mailing address
4390 Elmwood CT
Riverside, CA 92506-1138
Phone (951) 990-6516
Other practice location 1
4527 N 16th St Ste 201
Phoenix, AZ 85016-5352
Phone (951) 990-6516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95026834 | CA | MD | Registered Nurse |
| 332811 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
| 95036803 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Organizations & group practices 1
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Riverside, CA
- NPI 1144135518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1792540800000",
"number": "1417839077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4390 ELMWOOD CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925061138",
"telephone_number": "951-990-6516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11150 W OLYMPIC BLVD STE 780",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641829",
"telephone_number": "951-990-6516"
}
],
"practiceLocations": [
{
"address_1": "4527 N 16th St Ste 201",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850165352",
"country_code": "US",
"telephone_number": "951-990-6516",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHANDLER",
"first_name": "AUSTIN",
"middle_name": "JEFFREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-24",
"last_updated": "2026-10-21",
"certification_date": "2026-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95036803",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "AZ",
"license": "332811",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95036803",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95026834",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.