Healthcare Provider Details

I. General information

NPI: 1316240666
Provider Name (Legal Business Name): MAH AZAH AWOH PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2628 VICTOR AVE
REDDING CA
96002-1454
US

IV. Provider business mailing address

24301 BRAZOS TOWN XING
ROSENBERG TX
77471-6286
US

V. Phone/Fax

Practice location:
  • Phone: 281-638-0915
  • Fax: 281-572-8702
Mailing address:
  • Phone: 281-638-0915
  • Fax: 281-572-8702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61486344
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95028857
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: