NPIMap

Organization Active NPI

Tavarua Medical Rehabilitation Services

Doing business as Azusa Medical and Mental Health Services

  • Methadone Clinic
  • Azusa, CA
National Provider Identifier
1679848568
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
TAVARUA MEDICAL REHABILITATION SERVICES
Doing business as
Azusa Medical and Mental Health Services
Practice address
474 S Citrus Ave
Azusa, CA 91702-4733
Phone
(310) 678-7917
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Cynthia Ann Blanks
Title
Executive Director
Phone
(661) 254-6630

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary
Primary Care Clinic/Center 261QP2300X CA

Addresses

Primary practice location

474 S Citrus Ave
Azusa, CA 91702-4733

Mailing address

26460 Summit Cir
Santa Clarita, CA 91350-2991
Phone (626) 858-9500

Other names 1

  • Azusa Medical and Mental Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Azusa Medical and Mental Health Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1679848568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 SUMMIT CIR",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502991",
            "telephone_number": "626-858-9500",
            "fax_number": "626-858-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 S CITRUS AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917024733",
            "telephone_number": "310-678-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVARUA MEDICAL REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "BLANKS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "661-254-6630"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Azusa Medical and Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Azusa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.