Individual provider Active NPI

Christy Fallin, FNP-C

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1114699683
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95017221 Issued in CA
Practice address
1604 Blossom Hill Rd Ste 10
San Jose, CA 95124-6350
Phone
(408) 528-8833
Fax
(408) 827-4171
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017221 CA
Nurse Practitioner 363L00000X 95017221 CA Primary

Addresses

Primary practice location

1604 Blossom Hill Rd Ste 10
San Jose, CA 95124-6350

Mailing address

1604 Blossom Hill Rd Ste 10
San Jose, CA 95124-6350
Phone (408) 528-8833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250904002015 CA Practitioner - Nurse Practitioner 5092181446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
James Petros MD IncGroup PAC ID 0941479216, 21 clinicians

Practice addresses (Care Compare)

1604 Blossom Hill Rd
Suite 10
San Jose, CA 95124-6350
Phone (408) 528-8833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
James Petros, M.D., Inc. CurrentSince Jun 26, 2025 Accepting new patients
James Petros, M.D., Inc. CurrentSince Jun 26, 2025 Accepting new patients

Locations

14777 Los Gatos Blvd
Ste 202
Los Gatos, CA 95032
Phone (408) 528-8833

16275 Monterey St
Ste H
Morgan Hill, CA 95037
Phone (408) 528-8333

1604 Blossom Hill Rd
Ste 10
San Jose, CA 95124
Phone (408) 528-8833

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1114699683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 BLOSSOM HILL RD STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246350",
            "telephone_number": "408-528-8833",
            "fax_number": "408-827-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 BLOSSOM HILL RD STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246350",
            "telephone_number": "408-528-8833",
            "fax_number": "408-827-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLIN",
        "first_name": "CHRISTY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017221",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.