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BUENA PARK REHAB
NPI 1346934247
Clinic/Center - Rehabilitation, Substance Use Disorder in Fullerton, CA

Active since June 05, 2023CLIA 05D2316050 · Waiver
515 W COMMONWEALTH AVE STE 215, FULLERTON, CA 92832(310) 343-8684 Get Directions Write a Review

NPPES record last updated: November 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 1, 2023, Jun 5, 2023 (2 updates tracked since 2023).

About Buena Park Rehab NPPES

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

BUENA PARK REHAB (NPI 1346934247) is a healthcare organization registered as a rehabilitation, substance use disorder in Fullerton, California and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through December 25, 2026 and lists Mariam Goldberg, Manager, as its authorized official.

NPPES Registry Identity

NPI1346934247
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameBUENA PARK REHAB
Location Address515 W COMMONWEALTH AVE STE 215Fullerton, CA 92832-1752
Mailing Address515 W Commonwealth Ave Ste 215Fullerton, CA 92832-1752
Phone(310) 343-8684
Organization SubpartNo
Authorized OfficialMariam GoldbergManager · (310) 343-8684
Enumeration DateJune 5, 2023
Last NPPES UpdateNovember 1, 20232 updates tracked since enumeration
NPPES CertifiedNovember 1, 2023
✔ NPI 1346934247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedMarriage & Family TherapistTaxonomy 106H00000X
515 W COMMONWEALTH AVE STE 215, Fullerton, CA 92832
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2316050

Buena Park Rehab LLC · Fullerton, CA
Active · expires Dec 25, 2026
CLIA Number05D2316050
Laboratory TypeIop
Certificate Effective DateDecember 26, 2024
Certificate Expiration DateDecember 25, 2026
Laboratory DirectorJiseung Yoon
Laboratory Phone(310) 343-8684
Laboratory LocationBuena Park Rehab LLC515 W Commonwealth Ave #215, Fullerton, CA 92832
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Buena Park Rehab's NPI number?

The NPI number for Buena Park Rehab is 1346934247. It was assigned to this organization in the NPPES registry on June 5, 2023.

Where is Buena Park Rehab located?

Buena Park Rehab is located at 515 W Commonwealth Ave Ste 215, Fullerton, CA 92832. The listed phone number is (310) 343-8684.

What is Buena Park Rehab's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Does Buena Park Rehab hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2316050) is associated with this NPI, valid through December 25, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Buena Park Rehab was last updated on November 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.