Individual provider Active NPI

Joycelin Kinte Prothro, MSW

  • Mental Health Counselor
  • Pomona, CA
National Provider Identifier
1023137197
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19351 Issued in CA
Practice address
845 E Arrow Hwy
Pomona, CA 91767-2535
Phone
(909) 624-1233
Fax
(909) 621-5999
NPI assigned
Mar 28, 2007
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 19351 CA Primary

Addresses

Primary practice location

845 E Arrow Hwy
Pomona, CA 91767-2535

Mailing address

249 Grayson Way
Unit C
Upland, CA 91786-6370
Phone (909) 608-1499

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200305002665 CA Practitioner - Clinical Social Worker 6507293487 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19351CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 22, 2022 Accepting new patients
Healthright 360 Current Accepting new patients
Healthright 360 CurrentSince Jan 26, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 18, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Healthright 360 CurrentSince Jan 26, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

2650 E Foothill Blvd
Pasadena, CA 91107
Phone (212) 542-3838

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

831 E Arrow Hwy
Pomona, CA 91767
Phone (909) 398-4383

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1023137197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 GRAYSON WAY",
            "address_2": "UNIT C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866370",
            "telephone_number": "909-608-1499",
            "fax_number": "909-621-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 E ARROW HWY",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672535",
            "telephone_number": "909-624-1233",
            "fax_number": "909-621-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTHRO",
        "first_name": "JOYCELIN",
        "middle_name": "KINTE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "19351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.