Healthcare Provider Details

I. General information

NPI: 1730329855
Provider Name (Legal Business Name): MAILIN CHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W MISSION RD
ALHAMBRA CA
91803-1618
US

IV. Provider business mailing address

1515 W MISSION RD
ALHAMBRA CA
91803-1618
US

V. Phone/Fax

Practice location:
  • Phone: 626-943-3410
  • Fax:
Mailing address:
  • Phone: 626-943-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW66405
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberLCSW66405
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: