Provider Demographics
NPI:1306154133
Name:SHUNYA, RIGPA (NP)
Entity type:Individual
Prefix:MR
First Name:RIGPA
Middle Name:
Last Name:SHUNYA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:ADVIAT
Other - Middle Name:
Other - Last Name:ADVAIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3707 N STOCKTON HILL RD STE B
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-0507
Mailing Address - Country:US
Mailing Address - Phone:928-757-8111
Mailing Address - Fax:928-757-3256
Practice Address - Street 1:2187 SWANSON AVE
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-6838
Practice Address - Country:US
Practice Address - Phone:928-855-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201505063NP-PP363LP0808X
CA22032363LP0808X
NE113097363LP0808X
IAG133428364SP0808X
AZ238748363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ106035Medicaid