Individual
JUSTINA TENGUH AWAZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 ALHAMBRA AVE, MARTINEZ, CA 94553-3156
(510) 566-4872
Mailing address
2500 ALHAMBRA AVE, MARTINEZ, CA 94553-3156
(510) 566-4872
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
764451
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95023626
CA
Other
Enumeration date
01/20/2022
Last updated
01/04/2023
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