Individual provider Active NPI

Amanda M Chan, AMFT

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1992513865
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT149556 Issued in CA
Practice address
1686 Union St Ste 203
San Francisco, CA 94123-4509
Phone
(415) 569-6304
NPI assigned
Dec 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT149556 CA Primary

Addresses

Primary practice location

1686 Union St Ste 203
San Francisco, CA 94123-4509

Mailing address

4200 18TH St Ste 104
San Francisco, CA 94114-2449
Phone (415) 830-3440

Other practice location 1

4200 18th St Ste 104
San Francisco, CA 94114-2449
Phone (415) 830-3440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AMFT149556CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barton Shulman Psychotherapy, a Professional Clinical Counselor Corp CurrentSince Dec 29, 2024 Accepting new patients

Locations

4200 18th St
Ste 104
San Francisco, CA 94114
Phone (415) 569-6304

1686 Union St
Ste 203
San Francisco, CA 94123
Phone (415) 569-6304

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": "1734998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1992513865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 18TH ST STE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142449",
            "telephone_number": "415-830-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1686 UNION ST STE 203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234509",
            "telephone_number": "415-569-6304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 18th St Ste 104",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941142449",
            "country_code": "US",
            "telephone_number": "415-830-3440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-24",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT149556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.