Individual provider Active NPI

Stephanie Laura Chan, OD

  • Optometrist
  • Walnut Creek, CA
National Provider Identifier
1689635542
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11413T Issued in CA
Practice address
675 Ygnacio Valley Rd
Ste B103
Walnut Creek, CA 94596-3883
Phone
(925) 933-4700
Fax
(925) 933-4721
NPI assigned
Mar 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11413T CA Primary

Addresses

Primary practice location

675 Ygnacio Valley Rd
Ste B103
Walnut Creek, CA 94596-3883

Mailing address

675 Ygnacio Valley Rd
Ste B103
Walnut Creek, CA 94596-3883
Phone (925) 933-4700

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401001049 CA Practitioner - Optometry 0042517278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

675 Ygnacio Valley Rd
Suite B103
Walnut Creek, CA 94596-3883
Phone (925) 933-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11413TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Vision Care Optometry Optometrist CurrentSince Feb 21, 2016 Accepting new patients
Michael a. Roy, O.D. Inc. PastSince Oct 5, 2010 Accepting new patients

Locations

675 Ygnacio Valley Rd
Ste B103
Walnut Creek, CA 94596
Phone (925) 933-0270

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689635542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 YGNACIO VALLEY RD",
            "address_2": "STE B103",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963883",
            "telephone_number": "925-933-4700",
            "fax_number": "925-933-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 YGNACIO VALLEY RD",
            "address_2": "STE B103",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963883",
            "telephone_number": "925-933-4700",
            "fax_number": "925-933-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "STEPHANIE",
        "middle_name": "LAURA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11413T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.