Jennifer Chan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

126293 Issued in CA

Practice address

1200 Wilshire Blvd
Los Angeles, CA 90017-1908

Phone

(213) 258-8885

NPI assigned

Jul 30, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• California Hispanic Commission a & D Abuse

  • Community/Behavioral Health Agency
  • Pico Rivera, CA
  • NPI 1902055163
  NPD (past)
• Chcada/Enhanced Specialized Foster Care Mental HLTH Services

  • Community/Behavioral Health Agency
  • Pico Rivera, CA
  • NPI 1588860910
  NPD (past)

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1679829410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "213-481-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "213-258-8885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5628 E Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900402922",
            "country_code": "US",
            "telephone_number": "323-318-9960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9033 Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Pico Rivera",
            "state": "CA",
            "postal_code": "906603839",
            "country_code": "US",
            "telephone_number": "562-942-9625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "126293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "00000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Humphrey Chan, MD
• I-Chen Chan
• Jane Kit Ching Chan
• Janice Wan Ching Chan, DO
• Jason Earl Chan, M.D. PH.D.
• Jennifer Tan Chan, M.D.
• Jessica Loretta Chan, M.D.
• Joann Chan, PA
• Joseph Lawrence Chan, M.D.
• June Chan

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.