Provider Demographics
NPI:1164877213
Name:FORSYTHE, JOVANA LYNN (CADC II)
Entity Type:Individual
Prefix:MRS
First Name:JOVANA
Middle Name:LYNN
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:MISS
Other - First Name:JOVANA
Other - Middle Name:
Other - Last Name:BURDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RADT
Mailing Address - Street 1:PO BOX 3218
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93385-3218
Mailing Address - Country:US
Mailing Address - Phone:661-869-1795
Mailing Address - Fax:
Practice Address - Street 1:2920 H ST STE 101
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1926
Practice Address - Country:US
Practice Address - Phone:661-237-8200
Practice Address - Fax:661-325-3929
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1228690416101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)