Prototypes Centers for Innovation in Health, Mental Health and Social

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROTOTYPES CENTERS FOR INNOVATION IN HEALTH, MENTAL HEALTH AND SOCIAL

Practice address

831 E Arrow Hwy
Pomona, CA 91767-2535

Phone

(909) 398-4383

Fax

(909) 398-0127

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Cassandra Loch, LCSW, MBA

Title

President, Ceo

Phone

(213) 542-3838

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Prototypes Centers for Innovation in Health, Mental Health and Social Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Healthright 360

  • Community/Behavioral Health Agency
  • Pasadena, CA
  • NPI 1043336084

  O20110305000022

  Same enrollment
• Healthright 360

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1356643993

  O20110305000022

  Same enrollment
• Healthright 360

  • Substance Abuse Rehabilitation Facility
  • Pomona, CA
  • NPI 1457669475

  O20110305000022

  Same enrollment
• Healthright 360

  • Community/Behavioral Health Agency
  • Pasadena, CA
  • NPI 1487843876

  O20110305000022

  Same enrollment
• Prototypes Centers for Innovation in Health, Mental Health and Social

  • Community/Behavioral Health Agency
  • El Monte, CA
  • NPI 1508055971

  O20110305000022

  Same enrollment

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1003932047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N ALAMEDA ST",
            "address_2": "SUITE 390",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121804",
            "telephone_number": "213-542-3838",
            "fax_number": "213-225-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 E ARROW HWY",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672535",
            "telephone_number": "909-398-4383",
            "fax_number": "909-398-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTOTYPES CENTERS FOR INNOVATION IN HEALTH, MENTAL HEALTH AND SOCIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "LOCH",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "213-542-3838",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA COUNTY DMH",
            "identifier": "7569A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA COUNTY DMH",
            "identifier": "7568A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prototypes Centers for Innovation in Health, Mental Health and Social",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joycelin Kinte Prothro, MSW
• Prototypes
• Prototypes
• Prototypes
• Prototypes Centers for Innovation - Health, MH, & Social Services
• Prototypes Outpatient Services
• Albert Provencio
• Aleksei Pulchritudoff
• Natalie Pulido
• Krishna Anurag Pulumati, MD

• Community/Behavioral Health Agency in Pomona, CA
• Providers in Pomona, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.