DR. TARA FAIRBANKS
NPI 1750781118
Psychologist in Santa Monica, CA

Active since September 03, 2014Opted out of Medicare · through Apr 1, 2027
3301 OCEAN PARK BLVD STE 210, SANTA MONICA, CA 90405(323) 761-9591 Get Directions Write a Review

NPPES record last updated: October 30, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Tara Fairbanks NPPES

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

DR. TARA FAIRBANKS (NPI 1750781118) is an individual psychologist in Santa Monica, California, licensed in California (32174) and active in the NPI registry since September 2014. She has opted out of Medicare through April 1, 2027 and maintains a secondary practice location in Pacoima.

NPPES Registry Identity

NPI1750781118
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. TARA FAIRBANKS
Location Address3301 OCEAN PARK BLVD STE 210Santa Monica, CA 90405-3230
Mailing Address3301 Ocean Park Blvd Ste 210Santa Monica, CA 90405-3230 · (323) 761-9591
Sole ProprietorNo
Enumeration DateSeptember 3, 2014
Last NPPES UpdateOctober 30, 2020
NPPES CertifiedOctober 30, 2020
NPI 1750781118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · 32174
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

3301 OCEAN PARK BLVD STE 210, Santa Monica, CA 90405

Secondary Practice Location 1

Location 112450 Van Nuys Blvd, Suite 200Pacoima, CA 91331-1391 · Phone (818) 896-1161 ext. 325 · Fax (818) 896-5069

Other Identifiers 3

Medicaid7068CA
Medicaid7420CA
Medicaid6758CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Tara Fairbanks has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2025 through April 1, 2027.

Opt-Out Effective DateApril 1, 2025
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 7

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

Psychologist (Clinical)
3301 OCEAN PARK BLVD STE 210
SANTA MONICA, CA 90405
Psychologist (Clinical)
3301 OCEAN PARK BLVD STE 210
SANTA MONICA, CA 90405
Psychologist (Clinical)
3301 OCEAN PARK BLVD STE 210
SANTA MONICA, CA 90405
Psychologist (Clinical)
3301 OCEAN PARK BLVD STE 210
SANTA MONICA, CA 90405
Psychologist (Clinical)
3301 OCEAN PARK BLVD STE 210
SANTA MONICA, CA 90405
Clinic/Center (Adult Mental Health)
3301 OCEAN PARK BLVD STE 210
SANTA MONICA, CA 90405
Marriage & Family Therapist
3301 OCEAN PARK BLVD STE 210
SANTA MONICA, CA 90405

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 Fairbanks's NPI number?

The NPI number for Tara Fairbanks is 1750781118. It was assigned to this individual provider in the NPPES registry on September 3, 2014.

Where is Tara Fairbanks located?

Tara Fairbanks practices at 3301 Ocean Park Blvd Ste 210, Santa Monica, CA 90405. The listed phone number is (323) 761-9591.

What is Tara Fairbanks's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Tara Fairbanks enrolled in Medicare?

No. Tara Fairbanks has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Tara Fairbanks was last updated on October 30, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.