Healthcare Provider Details

I. General information

NPI: 1407772809
Provider Name (Legal Business Name): GABRIEL SENN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 EL CAMINO DEL TEATRO
LA JOLLA CA
92037-6338
US

IV. Provider business mailing address

132 S LASKY DR FL 2
BEVERLY HILLS CA
90212-1705
US

V. Phone/Fax

Practice location:
  • Phone: 503-896-8760
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139728
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: