John A Chellsen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY8979 Issued in CA

Practice address

2155 W March LN
Ste 2B
Stockton, CA 95207-6420

Phone

(209) 473-4211

Fax

(209) 473-0610

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e0d732aa-1d5c-42bf-b672-8fabe3feb437/

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.

• Inland Psychiatric Offices

  • Social Worker
  • Stockton, CA
  • NPI 1376668053
  NPD (past)
• Touro University Medical Group

  • Multi-Specialty Clinic/Center
  • Stockton, CA
  • NPI 1215573613
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669403580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 W MARCH LN",
            "address_2": "STE 2B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076420",
            "telephone_number": "209-473-4211",
            "fax_number": "209-473-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W MARCH LN",
            "address_2": "STE 2B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076420",
            "telephone_number": "209-473-4211",
            "fax_number": "209-473-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELLSEN",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carmen Chen
• Crystal I Chen, O.D.
• Dana Chen

• Clinical Psychologist in Stockton, CA
• Providers in Stockton, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.