Healthcare Provider Details

I. General information

NPI: 1023719945
Provider Name (Legal Business Name): GAYANE SAAKYAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 COURT ST STE 7
JACKSON CA
95642-2154
US

IV. Provider business mailing address

1201 ALHAMBRA BLVD STE 300
SACRAMENTO CA
95816-5241
US

V. Phone/Fax

Practice location:
  • Phone: 209-223-2034
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA203992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: