Provider Demographics
NPI:1194211151
Name:ALMONTE, JENELYN (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JENELYN
Middle Name:
Last Name:ALMONTE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 WELDON ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-3219
Mailing Address - Country:US
Mailing Address - Phone:956-245-2275
Mailing Address - Fax:
Practice Address - Street 1:1800 WESTERN AVE STE 204
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411-1353
Practice Address - Country:US
Practice Address - Phone:909-474-9952
Practice Address - Fax:909-474-9951
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily