Healthcare Provider Details

I. General information

NPI: 1174629984
Provider Name (Legal Business Name): RANI K FALCONER RN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RANI A KOKATNUR RN NP

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 NORTH R STREET
LOMPOC CA
93436-5226
US

IV. Provider business mailing address

300 N. SAN ANTONIO ROAD FIRST FLOOR, ROOM 107
SANTA BARBARA CA
93110-1316
US

V. Phone/Fax

Practice location:
  • Phone: 805-737-6400
  • Fax: 805-737-6458
Mailing address:
  • Phone: 805-681-5461
  • Fax: 805-681-5200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number9645
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierCB241739
Identifier TypeOTHER
Identifier StateCA
Identifier IssuerMEDICARE ID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: