BUENA PARK REHAB
NPI 1346934247
Clinic/Center - Rehabilitation, Substance Use Disorder in Fullerton, CA
NPI Status: Active since June 05, 2023
Contact Information
515 W COMMONWEALTH AVE STE 215
FULLERTON, CA
ZIP 92832
Phone: (310) 343-8684
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
- CLIA Number: 05D2316050
- CLIA Cert. Type: Other - IOP
- CLIA Exp. Date: 12-25-2026
About BUENA PARK REHAB
This page provides the complete NPI Profile along with additional information for Buena Park Rehab, a provider established in Fullerton, California operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1346934247 assigned on June 2023. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Buena Park Rehab operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Mariam Goldberg (Manager)
- NPI
- 1346934247
- Provider Name
- BUENA PARK REHAB
- Entity Type
- Organization
- Location Address
- 515 W COMMONWEALTH AVE STE 215 FULLERTON, CA 92832
- Location Phone
- (310) 343-8684
- Mailing Address
- 515 W COMMONWEALTH AVE STE 215 FULLERTON, CA 92832
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-05-2023
- Last Update Date
- 11-01-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | |
| 3 | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2316050
- Facility Type
- Other - IOP
- Certificate Effective Date
- December 26, 2024
- Certificate Expiration Date
- December 25, 2026
- Laboratory Director
- JISEUNG YOON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Buena Park Rehab to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 4 | 6 | 9 | 3 | 4 | 2 | 4 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 8 | 6 | 18 | 3 | 8 | 2 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 8 + 6 + 1 + 8 + 3 + 8 + 2 + 8 + 24 = 73 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 73 = 7 | 7 | ||||||||
The NPI number 1346934247 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1346934247, enumerated in the NPI registry as an "organization" on June 05, 2023
The provider is located at 515 W Commonwealth Ave Ste 215 Fullerton, Ca 92832 and the phone number is (310) 343-8684
This medical organization specializes in Clinic/Center with taxonomy code 261QR0405X with a focus in Rehabilitation, Substance Use Disorder
The provider's CLIA number is 05D2316050 for a "other - iop" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on June 05, 2023. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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