Traci Allison Chamberlain, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95025995 Issued in CA

Practice address

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556

Phone

(925) 282-1778

Fax

(415) 296-5299

NPI assigned

Jul 3, 2019

Sex

Female

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

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Mehboob Makhani MD a Professional CorporationGroup PAC ID 9133387442, 9 clinicians

Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.tracichamberlain@148377.advancedmd-direct.com

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.

• Mehboob Makhani MD a Professional Corporation

  • Psychiatry Physician
  • Northridge, CA
  • NPI 1578835724
  Medicare reassignment Care Compare group NPD
• Pacific Coast Psychiatric Associates Inc

  dba Lifestance Health

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment Care Compare group NPD
• Alliance for Wellness, Inc.

  • Psychiatry Physician
  • Inglewood, CA
  • NPI 1124329131

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Tamika Henry MD Inc

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1770381436
  NPD (past)

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1891357380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 S Central Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912042548",
            "country_code": "US",
            "telephone_number": "855-427-2778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 W Alondra Blvd",
            "address_purpose": "LOCATION",
            "city": "Compton",
            "state": "CA",
            "postal_code": "902203533",
            "country_code": "US",
            "telephone_number": "310-933-8755",
            "fax_number": "310-933-8378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "TRACI",
        "middle_name": "ALLISON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassandra Cervantes
• Cet Burbank LLC
• Nancy Cha
• Monique Chagolla
• Levon Chalabyan
• Chan and Segulyev Dental Corporation
• Justin K Chan
• Kevin Wayne Chan, M.D.
• Michael Chan, BCBA
• Chandler RX Inc (Chandler Pharmacy)

• Psychiatric/Mental Health Nurse Practitioner in Burbank, CA
• Providers in Burbank, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.