PROTOTYPES (NPI# 1568891612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568891612 |
| Entity Type | Organization |
| Organization Name | PROTOTYPES |
| Practice Address |
2555 E Colorado Blvd Suite 100-101 Pasadena CA 91107-6622 |
| Practice Telephone | 6265772261 |
| Practice Fax Number | 6265772543 |
| Mailing Telephone | 6265772261 |
| Mailing Fax Number | 6265772543 |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |
| Authorized Official Name | MS. REBECCA MEDINA SNYDER (SUPERVISOR II) |
| Authorized Official Telephone | 6265772261 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302F00000X | Exclusive Provider Organization | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457797540 | Prototypes | Case Management | 2555 E Colorado Blvd # 100, Pasadena, CA 91107-6622 | 2013-05-15 |
| 1659654986 | Prototypes | Licensed Vocational Nurse | 2555 E. Colorado Blvd, Suite 100-101, Pasadena, CA 91107 | 2011-09-22 |
| 1750587507 | Prototypes | Substance Abuse Rehabilitation Facility | 3755 Valle Vista Dr, Chino Hills, CA 91709-2943 | 2007-06-26 |
| 1245867241 | Prototypes | Counselor | 831 E Arrow Hwy, Pomona, CA 91767-2535 | 2020-03-27 |
| 1265069355 | Prototypes | Counselor | 831 E Arrow Hwy, Pomona, CA 91767-2535 | 2020-03-26 |
| 1164801643 | Prototypes | Case Management | 831 E Arrow Hwy, Pomona, CA 91767-2535 | 2015-05-29 |
| 1336571280 | Prototypes | Community/Behavioral Health | 2555 E Colorado Blvd, Ste.100, Pasadena, CA 91107-6622 | 2013-08-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROTOTYPES, INC. | Pike Tower 520 Pike St # 2600, Seattle, WA 98101-4001 |
| Street Address |
2555 E COLORADO BLVD SUITE 100-101 |
| City | PASADENA |
| State | CA |
| Zip Code | 91107-6622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467557371 | Kathryn Farrelly | Counselor | 2555 E Colorado Blvd, Suite 100, Pasadena, CA 91107-6622 | 2006-09-14 |
| 1407383995 | Laurelle Montagne | Occupational Therapist | 2555 E Colorado Blvd, Pasadena, CA 91107-6622 | 2017-05-16 |
| 1093255085 | Marillyn Bahamon | Licensed Vocational Nurse | 2555 E Colorado Blvd, Suite100, Pasadena, CA 91107-6622 | 2017-02-24 |
| 1710422332 | Yasmin Attia | Student in an Organized Health Care Education/Training Program | 2555 E Colorado Blvd, Suite 100, Pasadena, CA 91107-6622 | 2017-01-05 |
| 1194271726 | Keeley C Hart | Student in an Organized Health Care Education/Training Program | 2555 E Colorado Blvd, Suite 100, Pasadena, CA 91107-6622 | 2016-09-01 |
| 1003277021 | James Wong | Rehabilitation Practitioner | 2555 E Colorado Blvd, Suite 100, Pasadena, CA 91107-6622 | 2016-03-18 |
| 1477914562 | Alicia E Perez | Licensed Vocational Nurse | 2555 E Colorado Blvd, Suite 100, Pasadena, CA 91107-6622 | 2016-03-16 |
| 1902267735 | Marie Hernandez | Rehabilitation Practitioner | 2555 E Colorado Blvd, Suite 100, Pasadena, CA 91107-6622 | 2016-03-07 |
| 1801264007 | Kenda Woolfson | Student in an Organized Health Care Education/Training Program | 2555 E Colorado Blvd, #100, Pasadena, CA 91107-6622 | 2015-09-04 |
| 1184014169 | Grandcare Hospice Services LLC | Hospice Care, Community Based | 2555 E Colorado Blvd, Suite 400-b, Pasadena, CA 91107-6622 | 2015-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801412002 | Kwasi Nkansa | Physical Medicine & Rehabilitation | 2585 East Washington Blvd, Pasadena, CA 91107 | 2020-06-23 |
| 1609402742 | H & S Hospice Care Inc | Hospice Care, Community Based | 2525 E Colordo Blvd Suite 109, Pasadena, CA 91107 | 2020-03-20 |
| 1013557115 | Cindy Phun | Pharmacist | 3383 E Foothill Blvd, Pasadena, CA 91107 | 2020-01-07 |
| 1184185548 | Preferred Home Health Services | Home Health | 40 N Atlandena Dr Suite 219, Pasadena, CA 91107 | 2019-03-28 |
| 1861973729 | Julia E Underwood | Doula | 2335-115 E. Colorado Blvd #339, Pasadena, CA 91107 | 2018-08-28 |
| 1982183166 | Melissa Castillo | Counselor | 26 S Kinneloa Ave, Pasadena, CA 91107 | 2018-08-09 |
| 1083109904 | Lourice Boutros | Optometrist | 3235 E Colorado Blvd Ste 101, Pasadena, CA 91107 | 2018-06-22 |
| 1902313026 | Cecily Brogdon | Marriage & Family Therapist | 2115 Lambert Drive, Pasadena, CA 91107 | 2018-01-10 |
| 1790204915 | Vanessa Nicole Contreras | Licensed Vocational Nurse | 36 S. Kinneiloa Ave., Pasadena, CA 91107 | 2017-09-19 |
| 1730614397 | Rita Mason | Behavioral Analyst | 890 S Rosemead Blvd, Ste 45, Pasadena, CA 91107 | 2017-04-20 |
| Find all providers in zip 91107 | ||||
| Taxonomy Code | 302F00000X |
| Grouping | Managed Care Organizations |
| Classification | Exclusive Provider Organization |
| (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770723066 | Fei's Healing Center | Exclusive Provider Organization | 1 S Fair Oaks Ave, Suite 205, Pasadena, CA 91105-1945 | 2009-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407464290 | Carrot Fertility, Inc. | Exclusive Provider Organization | 47 Lusk St, San Francisco, CA 94107-1730 | 2020-07-17 |
| 1114573789 | Ed Sped Solutions, Inc. | Exclusive Provider Organization | 39159 Paseo Padre Pkwy Ste 205, Fremont, CA 94538-1623 | 2019-08-09 |
| 1114571916 | Kern Health Systems | Exclusive Provider Organization | 2900 Buck Owens Blvd., Bakersfield, CA 93308 | 2019-07-30 |
| 1962065904 | Stork Club Fertility, Inc. | Exclusive Provider Organization | 1 Bluxome Street, Suite 203, San Francisco, CA 94107-5518 | 2019-04-16 |
| 1023589249 | Janie Isabelle Currey | Exclusive Provider Organization | 30183 Cove View St, Canyon Lake, CA 92587-7981 | 2018-12-16 |
| 1922586114 | Primary Care Associates of California of San Diego, Inc. | Exclusive Provider Organization | 10833 Valley View St Ste 570, Cypress, CA 90630-5061 | 2018-07-31 |
| 1962949057 | Sol Play Child Therapy Inc | Exclusive Provider Organization | 5811 Amaya Dr Ste 204, La Mesa, CA 91942-4156 | 2017-01-26 |
| 1841735511 | E.moawad Dental Corporation | Exclusive Provider Organization | 402 S Long Beach Blvd, Compton, CA 90221-3428 | 2017-01-04 |
| 1538512744 | Azila Katherine Sabile Ortiz | Exclusive Provider Organization | 15260 Amalia St, San Diego, CA 92129-1228 | 2016-07-22 |
| 1730534330 | Northern California Physicians Network Inc | Exclusive Provider Organization | 2331 Montpelier Dr, San Jose, CA 95116-1688 | 2016-05-02 |
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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.