Provider Demographics
NPI:1083413660
Name:HILDEBRAND, GABRIELLE L (CMT CERT# 73094)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:L
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:CMT CERT# 73094
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1309
Mailing Address - Country:US
Mailing Address - Phone:415-216-7612
Mailing Address - Fax:
Practice Address - Street 1:881 SAN BRUNO AVE W
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3413
Practice Address - Country:US
Practice Address - Phone:650-476-6299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73094225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist