Active NPI
Marc E Chaney, PSYD
- Clinical Child & Adolescent Psychologist
- Orange, CA
National Provider Identifier
1568112613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 35002
- Practice address
- 1201 W la Veta Ave
Orange, CA 92868-4203 - Phone
- (714) 509-7419
- NPI assigned
- Mar 23, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 35002 | CA | Primary |
Addresses
Primary practice location
1201 W la Veta Ave
Orange, CA 92868-4203
Mailing address
1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 509-7419
Other practice location 1
2003 Stults Rd Ste 105
Huntington, IN 46750-1291
Phone (260) 356-3611
Other practice location 2
420 W 5th Ave
Flint, MI 48503-2445
Phone (810) 496-5677
Other practice location 3
1125 S Linden Rd Ste 200
Flint, MI 48532-4073
Phone (810) 262-2320
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 |
|---|---|---|---|
| 35002 | CA | MD | General Practice Dentistry |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1568112613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-509-7419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-509-7419"
}
],
"practiceLocations": [
{
"address_1": "2003 Stults Rd Ste 105",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "IN",
"postal_code": "467501291",
"country_code": "US",
"telephone_number": "260-356-3611",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "420 W 5th Ave",
"address_purpose": "LOCATION",
"city": "Flint",
"state": "MI",
"postal_code": "485032445",
"country_code": "US",
"telephone_number": "810-496-5677",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1125 S Linden Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Flint",
"state": "MI",
"postal_code": "485324073",
"country_code": "US",
"telephone_number": "810-262-2320",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHANEY",
"first_name": "MARC",
"middle_name": "E",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-23",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "35002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.