NPIMap

Organization Active NPI

Credena Health LLC

Doing business as Credena Health Pharmacy Orange

  • Pharmacy
  • Orange, CA
National Provider Identifier
1205811601
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CREDENA HEALTH LLC
Doing business as
Credena Health Pharmacy Orange
Practice address
1140 W la Veta Ave
Orange, CA 92868-4225
Phone
(714) 744-8724
Fax
(714) 744-8676
NPI assigned
Dec 8, 2005
Last updated
Oct 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Authorized official

Name
Mr. Adam Saulles
Title
Senior Director Pharmacy
Phone
(425) 358-9786

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1140 W la Veta Ave
Orange, CA 92868-4225

Mailing address

PO Box 2704
Portland, OR 97208-2704

Other names 1

  • Credena Health Pharmacy Orange Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20200831003396 CA Part B Supplier - Pharmacy 7810207206 3 other NPIs on this enrollment
Practice locations: Burbank, CA; Fullerton, CA; Orange, CA; Tarzana, CA
O20200930000824 CA DME Supplier - Pharmacy 7810207206 Practice locations: Orange, CA
O20201001001343 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7810207206 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burbank, CA; Fullerton, CA; Orange, CA; Tarzana, CA

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Credena Health LLC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Member organizations 7

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792627200000",
    "number": "1205811601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2704",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684225",
            "telephone_number": "714-744-8724",
            "fax_number": "714-744-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREDENA HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-08",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A",
        "authorized_official_last_name": "SAULLES",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "SENIOR DIRECTOR PHARMACY",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Credena Health Pharmacy Orange",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Credena Health Pharmacy Orange",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.