WILLIAM CHAN PSY.D.
NPI 1376033084
Psychologist - Clinical in Burlingame, CA

Q: What is William Chan's NPI number?

The NPI number for William Chan is 1376033084. It was assigned to this individual provider in the NPPES registry on May 17, 2018.

Q: What is William Chan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is William Chan enrolled in Medicare?

No. William Chan has opted out of Medicare through August 28, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for William Chan was last updated on May 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since May 17, 2018Opted out of Medicare · through Aug 28, 2026

877 MAHLER RD STE 160, BURLINGAME, CA 94010(650) 822-1057(650) 563-5570 Get Directions Write a Review

NPPES record last updated: May 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 23, 2025, Aug 21, 2023, May 15, 2023 and 5 more (8 updates tracked since 2018).

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About William Chan Psy.d. NPPES

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

WILLIAM CHAN PSY.D. (NPI 1376033084) is an individual clinical provider in Burlingame, California, licensed in California (PSY33550) and active in the NPI registry since May 2018. He has opted out of Medicare through August 28, 2026.

NPPES Registry Identity

NPI1376033084

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameWILLIAM CHANCredential: PSY.D.

Location Address877 MAHLER RD STE 160Burlingame, CA 94010-1640

Mailing Address877 Mahler Rd Ste 160Burlingame, CA 94010-1640 · (650) 822-1057 · Fax (650) 563-5570

Phone(650) 822-1057

Fax(650) 563-5570

Sole ProprietorNo

Enumeration DateMay 17, 2018

Last NPPES UpdateMay 23, 20258 updates tracked since enumeration

NPPES CertifiedMay 23, 2025

✔ NPI 1376033084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · PSY33550

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

877 MAHLER RD STE 160, Burlingame, CA 94010

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

William Chan Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 28, 2022 through August 28, 2026.

Opt-Out Effective DateAugust 28, 2022

Opt-Out In Effect ThroughAugust 28, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

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

DR. RORY TOLENTINO PETTIGREW PSY.D.

Psychologist (Clinical)

877 MAHLER RD STE 160
BURLINGAME, CA 94010

San Mateo County (650) 822-1057

BANYAN PSYCHOLOGY INC.

Psychologist (Clinical)

877 MAHLER RD STE 160
BURLINGAME, CA 94010

San Mateo County (650) 822-1057

YATONG JI

Student in an Organized Health Care Education/Training Program

877 MAHLER RD STE 160
BURLINGAME, CA 94010

San Mateo County (650) 822-1095

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 William Chan's NPI number?

The NPI number for William Chan is 1376033084. It was assigned to this individual provider in the NPPES registry on May 17, 2018.

Where is William Chan located?

William Chan practices at 877 Mahler Rd Ste 160, Burlingame, CA 94010. The listed phone number is (650) 822-1057.

What is William Chan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is William Chan enrolled in Medicare?

No. William Chan has opted out of Medicare through August 28, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for William Chan was last updated on May 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.