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Individual

AYANNA DENEE FORKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5325 BRODER BLVD, DUBLIN, CA 94568-3309
(408) 220-5145
Mailing address
5325 BRODER BLVD, DUBLIN, CA 94568-3309

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
20462
CA
101YP2500X
Professional Counselor
Primary
21968
CA
171M00000X
Case Manager/Care Coordinator
CA

Other

Enumeration date
07/06/2016
Last updated
02/27/2026
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