Justina Tenguh Awazi
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Martinez, CA
NPI 1649922758 · NPPES record last updated Jan 4, 2023
Key facts
- NPI
- 1649922758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 95023626 (CA)
- Practice address
- 2500 Alhambra Ave
Martinez, CA 94553-3156 - Phone
- (510) 566-4872
- NPI assigned
- Jan 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Contra Costa County
Practice addresses (Care Compare)
2311 Loveridge Rd
Pittsburg, CA 94565-5117
2523 El Portal Dr
San Pablo, CA 94806-3305
Phone (510) 215-3730
Hospital & facility affiliations
- Contra Costa Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230808001503 | CA | Practitioner - Nurse Practitioner | 5597127597 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 764451 | CA | MD | Psychiatric/Mental Health Registered Nurse |
| 95023626 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Contra Costa County | Multi-Specialty | Current | Accepting new patients |
| Contra Costa County | Current |
Accepting new patients | |
| Contra Costa County | Current |
Accepting new patients |
Locations
2500 Alhambra Ave
Martinez, CA 94553
Phone (925) 370-5000
2311 Loveridge Rd
Fl 1
Pittsburg, CA 94565
Phone (925) 431-2600
2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse |
163WP0808X | 764451 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95023626 | CA | Yes |
Addresses
Primary practice location
2500 Alhambra Ave
Martinez, CA 94553-3156
Mailing address
2500 Alhambra Ave
Martinez, CA 94553-3156
Phone (510) 566-4872
Other providers in Martinez, CA
- Atom Acupuncture Inc.
- Burt J Auerbach
- Autism Bloom LLC
- Winson Auyeung
- Cozette Aviles
- Cynthia Anne Ayala
- Seble Ayalew
- Marianna Ayers
- Kelsey Bacharz
- Amanda Kaye Backstrom
All providers in Martinez, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.