Provider Demographics
NPI:1710970959
Name:FALCON, PATRICIA A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:FALCON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85461
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85754-5461
Mailing Address - Country:US
Mailing Address - Phone:520-784-3265
Mailing Address - Fax:520-396-4154
Practice Address - Street 1:7624 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-4201
Practice Address - Country:US
Practice Address - Phone:520-303-4209
Practice Address - Fax:520-396-4154
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3388103G00000X, 103TR0400X, 103TH0004X
AZ003388103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ620006787OtherRAILROAD MEDICARE
AZ620006789OtherRAILROAD MEDICARE
AZ525321Medicaid
AZ620006787OtherRAILROAD MEDICARE
AZ525321Medicaid
AZ62822Medicare ID - Type Unspecified