Healthcare Provider Details

I. General information

NPI: 1720944580
Provider Name (Legal Business Name): JADE ELIZABETH MCGARRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47915 OASIS ST
INDIO CA
92201-6950
US

IV. Provider business mailing address

38031 TANDIKA TRL N
PALM DESERT CA
92211-7038
US

V. Phone/Fax

Practice location:
  • Phone: 510-306-5660
  • Fax:
Mailing address:
  • Phone: 949-363-3740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: