Healthcare Provider Details

I. General information

NPI: 1134820988
Provider Name (Legal Business Name): ROIRI SEAN JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EDMONDS RD
REDWOOD CITY CA
94062-3813
US

IV. Provider business mailing address

200 EDMONDS RD
REDWOOD CITY CA
94062-3813
US

V. Phone/Fax

Practice location:
  • Phone: 650-249-0445
  • Fax: 650-226-8097
Mailing address:
  • Phone: 650-249-0445
  • Fax: 650-226-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-HZOAVC
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: