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PROTOTYPES
NPI 1265069355
Counselor - Addiction (Substance Use Disorder) in Pomona, CA

Active since March 26, 2020
831 E ARROW HWY, POMONA, CA 91767(909) 624-1233 Get Directions Write a Review

NPPES record last updated: March 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Prototypes NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROTOTYPES (NPI 1265069355) is a healthcare organization registered as an addiction (substance use disorder) in Pomona, California and active in the NPI registry since March 2020. The organization lists Evanne Bree Jackson, Sud Counselor Ii, as its authorized official.

NPPES Registry Identity

NPI1265069355
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NamePROTOTYPES
Location Address831 E ARROW HWYPomona, CA 91767-2535
Mailing Address831 E Arrow HwyPomona, CA 91767-2535 · (909) 624-1233
Phone(909) 624-1233
Organization SubpartNo
Authorized OfficialEvanne Bree JacksonSud Counselor Ii · (909) 624-1233
Enumeration DateMarch 26, 2020
Last NPPES UpdateMarch 27, 2020
NPPES CertifiedMarch 27, 2020
✔ NPI 1265069355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
831 E ARROW HWY, Pomona, CA 91767
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIZBETH DIAZ ACSW
Social Worker
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 624-1233
PROTOTYPES CENTERS FOR INNOVATION IN HEALTH, MENTAL HEALTH AND SOCIAL
Community/Behavioral Health
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
ASILI MAISHA WILBOURN LVN
Licensed Vocational Nurse
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
MAYTE MURILLO
Case Manager/Care Coordinator
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
KELLI HUMPHREYS
Day Training/Habilitation Specialist
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
BRITTNEY LEE LCSW
Social Worker (Clinical)
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383
ELVIA VILLALOBOS RADT
Counselor (Addiction (Substance Use Disorder))
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 624-1233
JAIMIE BJUR
Student in an Organized Health Care Education/Training Program
831 E ARROW HWY
POMONA, CA 91767
Los Angeles County (909) 398-4383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prototypes's NPI number?

The NPI number for Prototypes is 1265069355. It was assigned to this organization in the NPPES registry on March 26, 2020.

Where is Prototypes located?

Prototypes is located at 831 E Arrow Hwy, Pomona, CA 91767. The listed phone number is (909) 624-1233.

What is Prototypes's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Prototypes was last updated on March 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.