Provider Demographics
NPI:1295556868
Name:AWOKE, DIBORAH
Entity type:Individual
Prefix:
First Name:DIBORAH
Middle Name:
Last Name:AWOKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94603-2558
Mailing Address - Country:US
Mailing Address - Phone:408-442-2339
Mailing Address - Fax:
Practice Address - Street 1:1811 S 7TH ST STE E
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6074
Practice Address - Country:US
Practice Address - Phone:408-442-2339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator