Healthcare Provider Details

I. General information

NPI: 1053296640
Provider Name (Legal Business Name): SAVANNAH KHAE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 FOREST AVE
PALO ALTO CA
94301-2622
US

IV. Provider business mailing address

1922 THE ALAMEDA
SAN JOSE CA
95126-1457
US

V. Phone/Fax

Practice location:
  • Phone: 650-323-1401
  • Fax: 408-642-6052
Mailing address:
  • Phone: 408-261-7777
  • Fax: 408-642-6052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: