Provider Demographics
NPI:1437025004
Name:GOLDENCREST PRIMARY CARE
Entity type:Organization
Organization Name:GOLDENCREST PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-751-4408
Mailing Address - Street 1:225 W HOSPITALITY LN STE 207
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3245
Mailing Address - Country:US
Mailing Address - Phone:909-751-4408
Mailing Address - Fax:909-751-4407
Practice Address - Street 1:225 W HOSPITALITY LN STE 207
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3245
Practice Address - Country:US
Practice Address - Phone:909-751-4408
Practice Address - Fax:909-751-4407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty