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COMMONWEALTH REHAB LLC
NPI 1730873548
Counselor - Addiction (Substance Use Disorder) in Fullerton, CA

Active since June 05, 2023CLIA 05D2316906 · Waiver
515 W COMMONWEALTH AVE STE 211, FULLERTON, CA 92832(310) 343-8684 Get Directions Write a Review

NPPES record last updated: September 15, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Commonwealth Rehab Llc NPPES

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

COMMONWEALTH REHAB LLC (NPI 1730873548) is a healthcare organization registered as an addiction (substance use disorder) in Fullerton, California and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through January 13, 2027 and lists Mariam Goldberg, Owner, as its authorized official.

NPPES Registry Identity

NPI1730873548
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NameCOMMONWEALTH REHAB LLC
Location Address515 W COMMONWEALTH AVE STE 211Fullerton, CA 92832-1752
Mailing Address515 W Commonwealth Ave Ste 211Fullerton, CA 92832-1752
Phone(310) 343-8684
Organization SubpartNo
Authorized OfficialMariam GoldbergOwner · (310) 343-8684
Enumeration DateJune 5, 2023
Last NPPES UpdateSeptember 15, 2023
NPPES CertifiedSeptember 15, 2023
✔ NPI 1730873548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedMarriage & Family TherapistTaxonomy 106H00000X
515 W COMMONWEALTH AVE STE 211, 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 05D2316906

Commonwealth Rehab LLC · Fullerton, CA
Active · expires Jan 13, 2027
CLIA Number05D2316906
Laboratory TypeIop
Certificate Effective DateJanuary 14, 2025
Certificate Expiration DateJanuary 13, 2027
Laboratory DirectorJiseung Yoon
Laboratory Phone(310) 343-8684
Laboratory LocationCommonwealth Rehab LLC515 W Commonwealth Ave #211, 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 Commonwealth Rehab LLC's NPI number?

The NPI number for Commonwealth Rehab LLC is 1730873548. It was assigned to this organization in the NPPES registry on June 5, 2023.

Where is Commonwealth Rehab LLC located?

Commonwealth Rehab LLC is located at 515 W Commonwealth Ave Ste 211, Fullerton, CA 92832. The listed phone number is (310) 343-8684.

What is Commonwealth Rehab LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Does Commonwealth Rehab LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2316906) is associated with this NPI, valid through January 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Commonwealth Rehab LLC was last updated on September 15, 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.