Individual provider Active NPI

Victoria J. Chan, NP

  • Family Nurse Practitioner
  • Toluca Lake, CA
National Provider Identifier
1831590322
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001315 Issued in CA
Practice address
4418 Vineland Avenue Suite 102
Toluca Lake, CA 91602
Phone
(818) 842-7145
Fax
(818) 842-8202
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001315 CA Primary

Addresses

Primary practice location

4418 Vineland Avenue Suite 102
Toluca Lake, CA 91602

Mailing address

4418 Vineland Avenue Suite 102
Toluca Lake, CA 91602
Phone (818) 842-7145

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150120002071 CA Practitioner - Nurse Practitioner 2264756352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premiere Medical Center of Burbank, Inc. CurrentSince Jan 19, 2015 Accepting new patients

Locations

4418 Vineland Ave
Ste 102
Toluca Lake, CA 91602
Phone (818) 842-7145

Organizations & group practices 1

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": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1831590322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 VINELAND AVENUE SUITE 102",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "91602",
            "telephone_number": "818-842-7145",
            "fax_number": "818-842-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4418 VINELAND AVENUE SUITE 102",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "91602",
            "telephone_number": "818-842-7145",
            "fax_number": "818-842-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "VICTORIA",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toluca Lake, CA

Sources for this page

Verify at the official NPI Registry.