Individual provider Active NPI

Austin Jeffrey Chandler

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1417839077
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95036803 Issued in CA
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, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
95026834CAMDRegistered Nurse
332811AZMDPsychiatric/Mental Health Nurse Practitioner
95036803CAMDPsychiatric/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.

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.

Verify at the official NPI Registry.