Individual provider Active NPI

Esmeralda Jazmin Garrido, PA-C

  • Physician Assistant
  • Moreno Valley, CA
National Provider Identifier
1952028334
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61867 Issued in CA
Practice address
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone
(909) 828-3258
NPI assigned
Oct 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X PA61867 CA
Physician Assistant 363A00000X PA61867 CA Primary

Addresses

Primary practice location

26520 Cactus Ave
Moreno Valley, CA 92555-3927

Mailing address

14698 Long View Dr
Fontana, CA 92337-2841
Phone (909) 828-3258

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117002617 CA Practitioner - Physician Assistant 5597113290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61867CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PA61867CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 19, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 19, 2025 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1952028334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14698 LONG VIEW DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923372841",
            "telephone_number": "909-828-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "909-828-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIDO",
        "first_name": "ESMERALDA",
        "middle_name": "JAZMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2024-12-30",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "PA61867",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.