Bryan Chan

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122240 Issued in CA

Practice address

11741 Telegraph Rd Ste G
Santa Fe Springs, CA 90670

Phone

(562) 942-8256

NPI assigned

Jul 28, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Through the Sea Marriage and Family Counseling Inc

  • Marriage & Family Therapist
  • West Covina, CA
  • NPI 1093281990
  Medicare reassignment NPD
• Descanso Home Health Services

  • Home Health Agency
  • Covina, CA
  • NPI 1437504990
  NPD (past)
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Ontario, CA
  • NPI 1902273923
  NPD (past)

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1528511227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11741 TELEGRAPH RD STE G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703687",
            "telephone_number": "562-942-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11741 TELEGRAPH RD STE G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "90670",
            "telephone_number": "562-942-8256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 Ramona Blvd",
            "address_2": "Suite I",
            "address_purpose": "LOCATION",
            "city": "Irwindale",
            "state": "CA",
            "postal_code": "917063752",
            "country_code": "US",
            "telephone_number": "626-337-3828 x204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13001 Ramona Blvd",
            "address_2": "Suite I",
            "address_purpose": "LOCATION",
            "city": "Irwindale",
            "state": "CA",
            "postal_code": "917063752",
            "country_code": "US",
            "telephone_number": "626-337-3828 x204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "BRYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF89959",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "PCCI2509",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Mary Cavanaugh
• Jessica Cazares
• Steven Celiz
• Lauren Cervantes
• Lizette Ailene Cervantes
• Ricardo Inguel Chang, MFT
• Jackson James Chavarria
• Juan-Carlos Chavarria
• Angela Chavez
• Anthony Eugene Chavez, L.C.S.W.

• Marriage & Family Therapist in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.