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JACQUELINE JIAQI CHAN PMHNP
NPI 1740988120
Nurse Practitioner - Psychiatric/Mental Health in Claremont, CA

Active since February 16, 2023PECOS EnrolledAccepts Medicare Assignment
675 W FOOTHILL BLVD STE 200, CLAREMONT, CA 91711(925) 282-1778(415) 296-5299 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 16, 2025, Feb 12, 2025, Aug 22, 2023 and 2 more (5 updates tracked since 2023).

About Jacqueline Jiaqi Chan Pmhnp NPPES

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

JACQUELINE JIAQI CHAN PMHNP (NPI 1740988120) is an individual psychiatric/mental health provider in Claremont, California, licensed in California (95025416) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Gardena, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1740988120
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJACQUELINE JIAQI CHANCredential: PMHNP
Location Address675 W FOOTHILL BLVD STE 200Claremont, CA 91711-3475
Mailing Address675 W Foothill Blvd Ste 200Claremont, CA 91711-3475 · (925) 282-1778 · Fax (415) 296-5299
Phone(925) 282-1778
Fax(415) 296-5299
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateFebruary 16, 2023
Last NPPES UpdateMay 16, 20255 updates tracked since enumeration
NPPES CertifiedMay 16, 2025
✔ NPI 1740988120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95025416
Also ListedRegistered NurseTaxonomy 163W00000X · License 95126081 (CA)
675 W FOOTHILL BLVD STE 200, Claremont, CA 91711
Open in Google Maps ↗

Secondary Practice Location 1

Location 11225 W 190th St Ste 280Gardena, CA 90248-4305 · Phone (626) 758-7788

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Jiaqi Chan Pmhnp 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 ID1658730585
PECOS Enrollment IDI20230821003857
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91711 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

EMANUEL VILLARREAL-SANDOVAL LCSW
Social Worker (Clinical)
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778
REBECCA ANN BECKETT RN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778
BLAIR KAYNE PAEZ-WONG LMFT
Marriage & Family Therapist
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778
ALICIA BEATRIZ MEDINA LMFT
Marriage & Family Therapist
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778
SANDRA SOFIA IBARRA LCSW
Social Worker (Clinical)
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778
VITUS CHIBUIKE ONUSURU LMFT
Marriage & Family Therapist
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778
MS. HILDA ANN WILLIAMSON LCSW
Social Worker (Clinical)
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778
STEPHANIE ROCHA LMFT
Marriage & Family Therapist
675 W FOOTHILL BLVD STE 200
CLAREMONT, CA 91711
Los Angeles County (925) 282-1778

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 Jacqueline Chan's NPI number?

The NPI number for Jacqueline Chan is 1740988120. It was assigned to this individual provider in the NPPES registry on February 16, 2023.

Where is Jacqueline Chan located?

Jacqueline Chan practices at 675 W Foothill Blvd Ste 200, Claremont, CA 91711. The listed phone number is (925) 282-1778.

What is Jacqueline Chan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jacqueline Chan enrolled in Medicare?

Yes. Jacqueline 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.

What insurance does Jacqueline Chan accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Jacqueline Chan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacqueline Chan was last updated on May 16, 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.