Provider Demographics
NPI:1164913133
Name:ROLEY, JASON SINGH (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:SINGH
Last Name:ROLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JASON
Other - Middle Name:SINGH
Other - Last Name:ROLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR JASON ROLEY
Mailing Address - Street 1:425 E SANTA CLARA ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95113-1936
Mailing Address - Country:US
Mailing Address - Phone:669-245-3428
Mailing Address - Fax:408-800-4095
Practice Address - Street 1:425 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1936
Practice Address - Country:US
Practice Address - Phone:669-245-3428
Practice Address - Fax:408-800-4095
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1650152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry