Khady Fall

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

PT36947 Issued in CA

Practice address

1887 Monterey Road
Suite 205
San Jose, CA 95112

Phone

(408) 961-4040

Fax

(402) 292-3640

NPI assigned

Jul 2, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1104443407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 TULLY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111048",
            "telephone_number": "408-896-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 MONTEREY ROAD",
            "address_2": "SUITE 205",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95112",
            "telephone_number": "408-961-4040",
            "fax_number": "402-292-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALL",
        "first_name": "KHADY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "PT36947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cali Maldonado Falcon, AMFT
• Robert M. Falconer, DPM
• Taylor Fales
• Delvia Michelle Falk
• Kirby Falk
• Christy Fallin, FNP-C
• John W Fallon, CAADAC
• Reysel Fallorina, RPH
• Oloruntoyin Omoyeni Falola, MD
• Familiar Surroundings Home Care, LLC.

• Behavior Technician in San Jose, CA
• Providers in San Jose, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.