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NPI Code Detail

MEDICARE: STEPHANY CHAN

MEDICARE:   STEPHANY  CHAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor70080CA

General Provider Information

NPI Number : 1932469947
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANY CHAN
Provider Business Mailing Address
First Line : 10901 MACARTHUR BLVD
Second Line : SUITE 202
City : OAKLAND
State : CA
Zip : 94605-5200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10901 MACARTHUR BLVD
Second Line : SUITE 202
City : OAKLAND
State : CA
Zip : 94605-5200
Country : US
Telephone Number : 510-430-1115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2012
Last Update Date : 05/23/2012

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Directions to “ STEPHANY CHAN ” Practice Location

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