Healthcare Provider Details

I. General information

NPI: 1467987271
Provider Name (Legal Business Name): GABRIANNA ELIZABETH ELISE SAKS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2017
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DUBOCE AVE # 250
SAN FRANCISCO CA
94117-3389
US

IV. Provider business mailing address

1500 S MAIN ST
FORT WORTH TX
76104-4917
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-5959
  • Fax:
Mailing address:
  • Phone: 817-702-1173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A18931
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number20A18931
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: