NPIMap

Organization Active NPI

Prototypes Outpatient Services

  • Community/Behavioral Health Agency
  • Pomona, CA
National Provider Identifier
1659575678
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROTOTYPES OUTPATIENT SERVICES
Practice address
831 E Arrow Hwy
Pomona, CA 91767-2535
Phone
(909) 398-4383
Fax
(909) 398-0127
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Carolyn Latta-Clark
Title
Director
Phone
(909) 398-4383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CA Primary

Addresses

Primary practice location

831 E Arrow Hwy
Pomona, CA 91767-2535

Mailing address

831 E Arrow Hwy
Pomona, CA 91767-2535
Phone (909) 398-4383

National Provider Directory

National Provider Directory
Tax ID family
Prototypes Womens Center Outpatient10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659575678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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 OUTPATIENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LATTA-CLARK",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-398-4383"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.