PROTOTYPES CENTERS FOR INNOVATION - HEALTH, MH, & SOCIAL SERVICES (NPI# 1861675431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861675431 |
| Entity Type | Organization |
| Organization Name | PROTOTYPES CENTERS FOR INNOVATION - HEALTH, MH, & SOCIAL SERVICES |
| Other Organization Name | PROTOTYPES CENTERS - HEALTH, MH, & SOCIAL SERVICES |
| Practice Address |
1890 N Garey Ave Pomona CA 91767-2923 |
| Mailing Address |
1000 N Alameda St Suite 390 Los Angeles CA 90012-1804 |
| Practice Telephone | 9096292400 |
| Practice Fax Number | 9096292445 |
| Mailing Telephone | 2135423838 |
| Mailing Fax Number | 2132250085 |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2010-11-30 |
| Authorized Official Name | CASSANDRA LOCH (PRESIDENT, CEO) |
| Authorized Official Telephone | 2135423838 |
| Authorized Official Credential | LCSW, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LA COUNTY DMH | 7568A | 01 |
| Other Name | Type Code |
|---|---|
| PROTOTYPES Centers - Health, MH, & Social Services | Other Name - Individual/Organization |
| Street Address |
1890 N GAREY AVE |
| City | POMONA |
| State | CA |
| Zip Code | 91767-2923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689855975 | Pristine Medical Group | Orthopaedic Surgery | 1890 N Garey Ave, Suite #b, Pomona, CA 91767-2923 | 2007-11-15 |
| 1043542152 | April Dawn Bonilla | Case Manager/Care Coordinator | 1890 N Garey Ave, Pomona, CA 91767-2923 | 2010-02-01 |
| 1972834745 | Candice Rosie Porras | Case Manager/Care Coordinator | 1890 N Garey Ave, Pomona, CA 91767-2923 | 2010-01-19 |
| 1073847547 | Indira Reyes | Case Manager/Care Coordinator | 1890 N Garey Ave, Pomona, CA 91767-2923 | 2009-09-30 |
| 1386977312 | Gaylynn Diane Hill | Case Manager/Care Coordinator | 1890 N Garey Ave, Pomona, CA 91767-2923 | 2009-09-09 |
| 1386877637 | Enrique Sinnel Sandoval | Counselor | 1890 N Garey Ave, Pomona, CA 91767-2923 | 2009-09-02 |
| 1932332293 | Adwoa Agnes Sefa-boakye | Counselor | 1890 N Garey Ave, Pomona, CA 91767-2923 | 2009-09-02 |
| 1912164492 | Stephanie A. Morales | Case Manager/Care Coordinator | 1890 N Garey Ave, Pomona, CA 91767-2923 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
| 1780205302 | Melanie Crystal Ramirez | Counselor | 845 East Arrow Hwy, Pomona, CA 91767 | 2020-05-05 |
| 1780249029 | Jean Hang | Pharmacist | 775 East Foothill Blvd, Pomona, CA 91767 | 2019-05-02 |
| 1679043269 | Christy Bloss | Counselor | 16029 Arrow Hwy. Suite G, Irwindale, CA 91767 | 2018-11-27 |
| 1740758895 | Pomona Community Health Center | Dentist | 1448 E Holt Avenue, Pomona, CA 91767 | 2018-11-07 |
| 1245749878 | Continental Post Acute LLC | Skilled Nursing Facility | 1912 N.san Antonio, Pomona, CA 91767 | 2017-09-26 |
| 1083134373 | Virginia Thompson | Counselor | 845 E. Arrow Hwy., Pomona, CA 91767 | 2017-06-27 |
| 1215489000 | Boys Republic - Pomona Residence | Community/Behavioral Health | 733 N Garey Ave, Pomona, CA 91767 | 2016-10-27 |
| 1164870499 | Karthikeyan Bhuvaneswaran | Psychiatry & Neurology | 255 E Bonita Ave Bldg Suite103, Pomona, CA 91767 | 2016-05-26 |
| 1679936777 | Nex's Traditional Chinese Medicine | Acupuncturist | 1150 N Garey Ave, Pomona, CA 91767 | 2016-04-05 |
| Find all providers in zip 91767 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653262 | Fernando Iniguez | Community/Behavioral Health | 404 W Alvarado St, Pomona, CA 91768-3015 | 2020-09-08 |
| 1972124378 | Rosa Guadalupe Garcia | Community/Behavioral Health | 1890 N Garey Ave Ste C, Pomona, CA 91767-2923 | 2020-04-27 |
| 1215489000 | Boys Republic - Pomona Residence | Community/Behavioral Health | 733 N Garey Ave, Pomona, CA 91767 | 2016-10-27 |
| 1700270188 | Hillsides | Community/Behavioral Health | 1902 Royalty Dr Ste 240&260, Pomona, CA 91767-3061 | 2015-03-24 |
| 1902223589 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 3 Cottontail Dr, Pomona, CA 91766 | 2014-03-21 |
| 1720404239 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 942 Barbara Ln, Pomona, CA 91767 | 2014-03-07 |
| 1801235973 | Medi-cure Health Services, Inc. | Community/Behavioral Health | 1444 E Holt Ave, Pomona, CA 91767-5865 | 2013-06-21 |
| 1073952149 | Medi-cure Health Services, Inc | Community/Behavioral Health | 1460 E Holt Ave # 430, Pomona, CA 91767-5856 | 2013-06-21 |
| 1427497593 | Medi-cure Health Seervices, Inc. | Community/Behavioral Health | 1460 E Holt Ave Ste 6, Pomona, CA 91767-5835 | 2013-06-21 |
| 1346594405 | Angie Wellness & Recovery Center | Community/Behavioral Health | 637 N Park Ave, Pomona, CA 91768-3669 | 2012-10-28 |
| Find all providers in POMONA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.