Healthcare Provider Details

I. General information

NPI: 1437938271
Provider Name (Legal Business Name): DENISE CHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9891 IRVINE CENTER DR STE 200
IRVINE CA
92618-4320
US

IV. Provider business mailing address

4216 ARPEGGIO AVE
SAN JOSE CA
95136-2304
US

V. Phone/Fax

Practice location:
  • Phone: 510-358-3177
  • Fax:
Mailing address:
  • Phone: 732-407-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: