Individual provider · Type 1 NPI
Charles Daniel Falconer, MSN, CRNP, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Modesto, CA
NPI number
1770143430
Active
Practice location
600 Coffee Rd
Modesto, CA 95355-4201
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Other practice locations
- 3425 Coffee Rd Ste A2, Modesto, CA 95355-1582 · (209) 524-9401
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 111054-23 (NH) |
| Registered Nurse | 163W00000X | 95410984 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95034112 (CA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | SP021192 (PA) |
| Registered Nurse | 163W00000X | 111054-21 (NH) |
| Registered Nurse | 163W00000X | RN694705 (PA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1770143430
Charles Daniel Falconer, MSN, CRNP, PMHNP-BC's National Provider Identifier is 1770143430, issued on Jun 15, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Modesto, CA. The record was last updated on Oct 29, 2025.