Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. ANDREA KWUN NING CHAN PSYD
NPI 1104375062
Psychologist in Campbell, CA

Active since October 03, 2016PECOS EnrolledAccepts Medicare Assignment
1925 S WINCHESTER BLVD STE 204, CAMPBELL, CA 95008(619) 354-7400 Get Directions Write a Review

NPPES record last updated: October 15, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 15, 2026, Mar 22, 2019, Jan 8, 2018 (3 updates tracked since 2018).

About Ms. Andrea Kwun Ning Chan Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. ANDREA KWUN NING CHAN PSYD (NPI 1104375062) is an individual psychologist in Campbell, California, licensed in California (30838) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Fremont, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1104375062
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMS. ANDREA KWUN NING CHANCredential: PSYD
Location Address1925 S WINCHESTER BLVD STE 204Campbell, CA 95008-1038
Mailing AddressPo Box 33508San Diego, CA 92163-3508 · (619) 354-7400
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateOctober 3, 2016
Last NPPES UpdateOctober 15, 20263 updates tracked since enumeration
NPPES CertifiedOctober 15, 2026
✔ NPI 1104375062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · 30838
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1925 S WINCHESTER BLVD STE 204, Campbell, CA 95008

Secondary Practice Location 1

Location 138950 Blacow Rd # D3Fremont, CA 94536-7379 · Phone (510) 379-9970

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Andrea Kwun Ning Chan Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678901378
PECOS Enrollment IDI20200311001962
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Andrea Chan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community/Behavioral Health
601 CLEMENT ST
San Francisco, CA 94118
  • Reassigned Medicare billing, California enrollment
  • 25 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
1925 S WINCHESTER BLVD STE 204
CAMPBELL, CA 95008

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrea Chan's NPI number?

The NPI number for Andrea Chan is 1104375062. It was assigned to this individual provider in the NPPES registry on October 3, 2016.

Where is Andrea Chan located?

Andrea Chan practices at 1925 S Winchester Blvd Ste 204, Campbell, CA 95008. The listed phone number is (619) 354-7400.

What is Andrea Chan's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Andrea Chan enrolled in Medicare?

Yes. Andrea Chan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Andrea Chan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Chan reassigns Medicare benefits to Richmond Area Multi-Services, Inc. (San Francisco, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrea Chan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Andrea Chan was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.