TARA RENEE TANAKA PH.D.
NPI 1114088184
Psychologist - Clinical in Vacaville, CA

Q: What is Tara Tanaka's NPI number?

The NPI number for Tara Tanaka is 1114088184. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Q: What is Tara Tanaka's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Tara Tanaka was last updated on March 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 13, 2006PECOS Enrolled

1600 CALIFORNIA DRIVE, VACAVILLE, CA 95696(707) 430-1165 Get Directions Write a Review

NPPES record last updated: March 29, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Tara Renee Tanaka Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA RENEE TANAKA PH.D. (NPI 1114088184) is an individual clinical provider in Vacaville, California, licensed in California (21641) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in San Francisco.

NPPES Registry Identity

NPI1114088184

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameTARA RENEE TANAKACredential: PH.D.

Location Address1600 CALIFORNIA DRIVEVacaville, CA 95696

Mailing AddressPo Box 2237Vacaville, CA 95696-8237 · (707) 430-1165

Phone(707) 430-1165

Sole ProprietorNo

Enumeration DateDecember 13, 2006

Last NPPES UpdateMarch 29, 2022

NPPES CertifiedMarch 15, 2022

✔ NPI 1114088184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · 21641

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1600 CALIFORNIA DRIVE, Vacaville, CA 95696

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Secondary Practice Location 1

Location 14141 Geary BlvdSan Francisco, CA 94118-3109 · Phone (415) 833-5103

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tara Renee Tanaka Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Tara Tanaka reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc

20 mi

Internal Medicine

975 SERENO DRIVE
Vallejo, CA 94589

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1336222397 (707) 651-1000

Sud Specialty Group - Ca

65 mi

Addiction Medicine

4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054

Reassigned Medicare billing, California enrollment
1,607 clinicians in this Medicare group

NPI 1972138238 (323) 205-7088

Grow Healthcare Group PC

69 mi

Mental Health

99 S ALMADEN BLVD STE 600
San Jose, CA 95113

Reassigned Medicare billing, California enrollment
3,139 clinicians in this Medicare group

NPI 1154994846 (408) 402-4385

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95696 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$191.95 typical visit price

range $65.02 – $191.95

Typical copayment $47.98 (range $16.25 – $47.98)

Most-billed visit code 99205

Established Patient

$113.05 typical visit price

range $21.86 – $157.69

Typical copayment $28.26 (range $5.46 – $39.42)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JOHN JAMES BARCLAY RPH

Pharmacist

1600 CALIFORNIA DRIVE
VACAVILLE, CA 95696

Solano County (707) 449-6595

MR. STIRLING C PRICE SOCIAL WORKER

Social Worker (Clinical)

1600 CALIFORNIA DRIVE
VACAVILLE, CA 95696

Solano County (707) 449-6504

DR. JOYCE W CORDOSI PSY.D.

Psychologist (Clinical)

1600 CALIFORNIA DRIVE
VACAVILLE, CA 95696

Solano County (707) 448-6841

MS. EILEEN JOY E ESPORO MSW, LCSW

Social Worker (Clinical)

1600 CALIFORNIA DRIVE
VACAVILLE, CA 95696

Solano County (707) 448-6841

MOLLY BRIDGET MALONE

Psychologist (Clinical)

1600 CALIFORNIA DRIVE
VACAVILLE, CA 95696

Solano County (707) 448-6841

DR. JOHN FANNIN LECKIE PH.D

Psychologist (Counseling)

1600 CALIFORNIA DRIVE
VACAVILLE, CA 95696

Solano County (707) 448-6841

MRS. ASHA MAHENDRA GANDHI M.D.

Psychiatry & Neurology (Forensic Psychiatry)

1600 CALIFORNIA DRIVE, DEPT. OF MENTAL HEALTH, DEPT. OF CORRECTIONS
VACAVILLE, CA 95696

Solano County (707) 449-6589

PAZ MOVIDO PACIFICO MD

Psychiatry & Neurology (Psychiatry)

1600 CALIFORNIA DRIVE
VACAVILLE, CA 95696

Solano County (707) 449-6582

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tara Tanaka's NPI number?

The NPI number for Tara Tanaka is 1114088184. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Where is Tara Tanaka located?

Tara Tanaka practices at 1600 California Drive, Vacaville, CA 95696. The listed phone number is (707) 430-1165.

What is Tara Tanaka's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Tara Tanaka enrolled in Medicare?

Yes. Tara Tanaka is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tara Tanaka's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tara Tanaka reassigns Medicare benefits to 3 organizations: Permanente Medical Group Inc (Vallejo, CA), Sud Specialty Group - Ca (Santa Clara, CA) and Grow Healthcare Group PC (San Jose, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tara Tanaka's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tara Tanaka was last updated on March 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.