NPIMap

Organization Active NPI

Prototypes Centers for Innovation - Health, MH, & Social Services

  • Community/Behavioral Health Agency
  • Pomona, CA
National Provider Identifier
1861675431
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROTOTYPES CENTERS FOR INNOVATION - HEALTH, MH, & SOCIAL SERVICES
Practice address
1890 N Garey Ave
Pomona, CA 91767-2923
Phone
(909) 629-2400
Fax
(909) 629-2445
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Cassandra Loch, LCSW, MBA
Title
President, Ceo
Phone
(213) 542-3838

Specialties & licenses 1

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

Addresses

Primary practice location

1890 N Garey Ave
Pomona, CA 91767-2923

Mailing address

1000 N Alameda St
Suite 390
Los Angeles, CA 90012-1804
Phone (213) 542-3838

Other identifiers 1

IdentifierTypeStateIssuer
7568AOtherCALA COUNTY DMH

Other names 1

  • PROTOTYPES Centers - Health, MH, & Social Services Other name

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.

Locations

1890 N Garey Ave
Pomona, CA 91767
Phone (909) 629-2400

Practitioners & affiliated clinicians

Practitioners 12

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": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1861675431",
    "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": "1890 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672923",
            "telephone_number": "909-629-2400",
            "fax_number": "909-629-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTOTYPES CENTERS FOR INNOVATION - HEALTH, MH, & SOCIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2010-11-30",
        "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_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": "7568A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROTOTYPES Centers - Health, MH, & Social Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 30, 2010; 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.