Provider Demographics
NPI:1396486601
Name:GARCIA GARIVO, JAZMIN (DPM)
Entity type:Individual
Prefix:DR
First Name:JAZMIN
Middle Name:
Last Name:GARCIA GARIVO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79405 HIGHWAY 111 STE 9-469
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-8300
Mailing Address - Country:US
Mailing Address - Phone:760-565-5545
Mailing Address - Fax:
Practice Address - Street 1:1180 N INDIAN CANYON DR STE W300
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4809
Practice Address - Country:US
Practice Address - Phone:760-565-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-02
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAE6126213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program