Shiree Segev Fatch, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A20222 Issued in CA

Practice address

1650 Lead Hill Blvd Ste 400
Roseville, CA 95661-3072

Phone

(916) 783-0580

Fax

(916) 783-1824

NPI assigned

Apr 1, 2019

Reactivated

Aug 7, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfatch120762@direct-ucsfmedicalcenter.org

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.

• Shiree Fatch Medical Corporation

  • Pediatrics Physician
  • Roseville, CA
  • NPI 1063209237
  NPD Authorized official

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1659833549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD STE 400",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613072",
            "telephone_number": "916-783-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD STE 400",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613072",
            "telephone_number": "916-783-0580",
            "fax_number": "916-783-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATCH",
        "first_name": "SHIREE",
        "middle_name": "SEGEV",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "deactivation_date": "2025-06-20",
        "reactivation_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A20222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Farooq, DO
• Anne-Marie Farr, MS, PPS
• Ian Ongman Farr, LMFT
• Megan Farris
• Jonathan Fat
• Huda Fatlawi, DDS
• Clifford Leo Faubert
• Nathalie Ramatou Faustino-Kuglen
• Christian Favero
• P. Scott Favero, D.M.D., M.S.

• Pediatrics Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.