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DR. TANISHA FAIRGOOD LMFT
NPI 1275957359
Marriage & Family Therapist in Roseville, CA

Active since February 10, 2014PECOS Enrolled
1624 SANTA CLARA DR STE 145, ROSEVILLE, CA 95661(916) 206-8548 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 11, 2022, May 23, 2017 (2 updates tracked since 2017).

About Dr. Tanisha Fairgood Lmft NPPES

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

DR. TANISHA FAIRGOOD LMFT (NPI 1275957359) is an individual marriage & family therapist in Roseville, California, licensed in California (99693) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275957359
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameDR. TANISHA FAIRGOODCredential: LMFT
Location Address1624 SANTA CLARA DR STE 145Roseville, CA 95661-3500
Mailing Address1624 Santa Clara Dr., Suite 145Roseville, CA 95661
Phone(916) 206-8548
Sole ProprietorYes
Enumeration DateFebruary 10, 2014
Last NPPES UpdateFebruary 11, 20222 updates tracked since enumeration
✔ NPI 1275957359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
Licenses✔ Licensed in CA · 99693✔ Licensed in CA · IMF69306
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1624 SANTA CLARA DR STE 145, Roseville, CA 95661
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tanisha Fairgood Lmft 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 Reassignment

Medicare enrollment records show Tanisha Fairgood reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
50 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

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

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.

SARAH MARIE MARTINEZ BEHAVIOR SPECIALIST
Case Manager/Care Coordinator
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 779-2455
CHRISTOPHER PAUL BOYER
Case Manager/Care Coordinator
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 298-6157
CAROLYN BAHOH JAVETE PSY.D
Psychologist (Clinical)
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 764-7022
JUDY DANIELLE BACUS
Case Manager/Care Coordinator
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 779-2455
LAUREEN NOVINA DRISCOLL
Community Health Worker
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 779-2475
STEPHANIE RENEE LAMBERT
Peer Specialist
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 779-2455
MARITZA S GONZALEZ
Student in an Organized Health Care Education/Training Program
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 779-2457
PACIFIC CLINICS
Community/Behavioral Health
1624 SANTA CLARA DR STE 145
ROSEVILLE, CA 95661
Placer County (916) 779-2455

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 Tanisha Fairgood's NPI number?

The NPI number for Tanisha Fairgood is 1275957359. It was assigned to this individual provider in the NPPES registry on February 10, 2014.

Where is Tanisha Fairgood located?

Tanisha Fairgood practices at 1624 Santa Clara Dr Ste 145, Roseville, CA 95661. The listed phone number is (916) 206-8548.

What is Tanisha Fairgood's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Tanisha Fairgood enrolled in Medicare?

Yes. Tanisha Fairgood is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tanisha Fairgood's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tanisha Fairgood reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The 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 Tanisha Fairgood'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 Tanisha Fairgood was last updated on February 11, 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.