Provider Demographics
NPI:1760190177
Name:SACKS, BEN
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:SACKS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 FRANKLIN ST APT 401
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3455
Mailing Address - Country:US
Mailing Address - Phone:415-831-1373
Mailing Address - Fax:
Practice Address - Street 1:1835 FRANKLIN ST APT 401
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3455
Practice Address - Country:US
Practice Address - Phone:415-831-1373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141189106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist