Provider Demographics
NPI:1083281372
Name:KASS, GABRIELA (LPCC)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:KASS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:
Other - Last Name:ROTHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3298 GOVERNOR DR UNIT 22566
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92192-5022
Mailing Address - Country:US
Mailing Address - Phone:858-215-1587
Mailing Address - Fax:
Practice Address - Street 1:3298 GOVERNOR DR UNIT 22566
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92192-5022
Practice Address - Country:US
Practice Address - Phone:858-215-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC16605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health