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NPI Code Detail

MEDICARE: JENNIFER GARNICA

MEDICARE:   JENNIFER  GARNICA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantAZ
2390200000XStudent in an Organized Health Care Education/Training ProgramAZ

General Provider Information

NPI Number : 1962354761
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER GARNICA
Provider Business Mailing Address
First Line : 4645 E WAYLAND RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85040-4154
Country : US
Telephone Number : 623-633-9439
Fax Number :
Provider Business Practice Location Address
First Line : 4645 E WAYLAND RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85040-4154
Country : US
Telephone Number : 623-633-9439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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