Healthcare Provider Details

I. General information

NPI: 1891408258
Provider Name (Legal Business Name): SKYE GARMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14063 CAMPO RD
JAMUL CA
91935-3205
US

IV. Provider business mailing address

14063 CAMPO RD
JAMUL CA
91935-3205
US

V. Phone/Fax

Practice location:
  • Phone: 619-534-3957
  • Fax:
Mailing address:
  • Phone: 619-534-3957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: