Active NPI
Candice Rosie Porras, A.A.
- Addiction (Substance Use Disorder) Counselor
- Bloomington, CA
National Provider Identifier
1972834745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 18612 Santa Ana Ave
Bloomington, CA 92316-2639 - Phone
- (909) 421-7120
- NPI assigned
- Jan 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CA | Primary |
Addresses
Primary practice location
18612 Santa Ana Ave
Bloomington, CA 92316-2639
Mailing address
18612 Santa Ana Ave
Bloomington, CA 92316-2639
Phone (909) 421-7120
Other practice location 1
1890 N Garey Ave
Pomona, CA 91767-2923
Phone (909) 629-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ICAN877 | Other | CA | LA COUNTY DMH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Associate of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prototypes Centers for Innovation - Health, MH, & Social Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Pomona, CA
- NPI 1861675431
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1972834745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18612 SANTA ANA AVE",
"city": "BLOOMINGTON",
"state": "CA",
"postal_code": "923162639",
"telephone_number": "909-421-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18612 SANTA ANA AVE",
"city": "BLOOMINGTON",
"state": "CA",
"postal_code": "923162639",
"telephone_number": "909-421-7120"
}
],
"practiceLocations": [
{
"address_1": "1890 N Garey Ave",
"address_purpose": "LOCATION",
"city": "Pomona",
"state": "CA",
"postal_code": "917672923",
"country_code": "US",
"telephone_number": "909-629-2400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PORRAS",
"first_name": "CANDICE",
"middle_name": "ROSIE",
"name_prefix": "Ms.",
"credential": "A.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-19",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA COUNTY DMH",
"identifier": "ICAN877",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.