Healthcare Provider Details

I. General information

NPI: 1508775826
Provider Name (Legal Business Name): GABRIELLE MALIA SANBORN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 WAILUKU DR STE 5A
HILO HI
96720-2488
US

IV. Provider business mailing address

955 HOOLAULEA ST
HILO HI
96720-3655
US

V. Phone/Fax

Practice location:
  • Phone: 808-785-3293
  • Fax:
Mailing address:
  • Phone: 808-315-3910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: