Healthcare Provider Details

I. General information

NPI: 1235344086
Provider Name (Legal Business Name): TAVARUA HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8207 WHITTIER BLVD
PICO RIVERA CA
90660-2521
US

IV. Provider business mailing address

26460 SUMMIT CIR
SANTA CLARITA CA
91350-2991
US

V. Phone/Fax

Practice location:
  • Phone: 562-695-0737
  • Fax: 562-695-0413
Mailing address:
  • Phone: 661-254-6630
  • Fax: 661-254-6644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number19-107
License Number StateCA

VIII. Authorized Official

Name: CYNTHIA ANN BLANKS
Title or Position: C E O
Credential:
Phone: 661-254-6630