Provider Demographics
NPI:1366084808
Name:SEN, DIYA (LMFT)
Entity type:Individual
Prefix:
First Name:DIYA
Middle Name:
Last Name:SEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:BROOKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95007-0251
Mailing Address - Country:US
Mailing Address - Phone:650-722-1538
Mailing Address - Fax:
Practice Address - Street 1:15814 WINCHESTER BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-3333
Practice Address - Country:US
Practice Address - Phone:831-288-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115502106H00000X
CALMFT125796106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist