Individual provider Active NPI

Stephanie Chen, M.D.

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1629509534
Registry record updated Jul 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A157400 Issued in CA
Practice address
5060 Shoreham PL Ste 100
San Diego, CA 92122-5904
Phone
(858) 427-5060
Fax
(619) 383-6701
NPI assigned
Mar 22, 2017
Last updated
Jul 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Psychiatry Physician 2084P0800X A157400 CA Primary

Addresses

Primary practice location

5060 Shoreham PL Ste 100
San Diego, CA 92122-5904

Mailing address

5060 Shoreham PL Ste 330
San Diego, CA 92122-5976
Phone (619) 417-6803

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220920002730 CA Practitioner - Psychiatry 9133504657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Southern California Keck School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 8628463015, 180 clinicians

Practice addresses (Care Compare)

5060 Shoreham PL
Suite 330
San Diego, CA 92122-5976
Phone (858) 427-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A157400CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sokyahealth Medical Group PC Multi-Specialty CurrentSince Jun 9, 2022 Accepting new patients
Shashita Inamdar MD Professional Corporation Multi-Specialty Past Accepting new patients

Locations

2386 Faraday Ave
Ste 110
Carlsbad, CA 92008
Phone (858) 427-5060

5060 Shoreham Pl
Ste 330
San Diego, CA 92122
Phone (619) 866-0998

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: stephanie.chen.p1@direct.sokya.nextgenshare.com

Organizations & group practices 2

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625356800000",
    "number": "1629509534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 SHOREHAM PL STE 330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225976",
            "telephone_number": "619-417-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 SHOREHAM PL STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225904",
            "telephone_number": "858-427-5060",
            "fax_number": "619-383-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "STEPHANIE",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-07-04",
        "certification_date": "2021-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A157400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.