NPIMap

Organization Active NPI

Tavarua Rehabilitation Services

  • Methadone Clinic
  • Azusa, CA
National Provider Identifier
1841679131
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
TAVARUA REHABILITATION SERVICES
Practice address
474 S Citrus Ave
Azusa, CA 91702-4733
Phone
(626) 858-9500
Fax
(626) 858-9090
NPI assigned
May 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Pramesh P Sharma
Title
Administrat Director
Phone
(661) 313-5503

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X RW4776 CA
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

474 S Citrus Ave
Azusa, CA 91702-4733

Mailing address

474 S Citrus Ave
Azusa, CA 91702-4733
Phone (626) 858-9500

National Provider Directory

National Provider Directory
Tax ID family
Tavarua Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1841679131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 S CITRUS AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917024733",
            "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": "626-858-9500",
            "fax_number": "626-858-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVARUA REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "PRAMESH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRAT  DIRECTOR",
        "authorized_official_telephone_number": "661-313-5503"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RW4776",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 31, 2025; 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.