Healthcare Provider Details

I. General information

NPI: 1861634115
Provider Name (Legal Business Name): SUNCREST HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12598 CENTRAL AVE STE 201
CHINO CA
91710-3530
US

IV. Provider business mailing address

12598 CENTRAL AVE STE 201
CHINO CA
91710-3530
US

V. Phone/Fax

Practice location:
  • Phone: 909-399-1122
  • Fax: 909-399-1115
Mailing address:
  • Phone: 909-399-1122
  • Fax: 909-399-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: GENE JOHN CARVAJAL MABASA
Title or Position: CEO
Credential:
Phone: 909-399-1122