Provider Demographics
NPI:1912614611
Name:MAIGUA, JAMES NDUNGU (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:NDUNGU
Last Name:MAIGUA
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36322 W ALHAMBRA ST
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-5308
Mailing Address - Country:US
Mailing Address - Phone:480-434-3251
Mailing Address - Fax:
Practice Address - Street 1:8222 S 48TH ST STE 120
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5368
Practice Address - Country:US
Practice Address - Phone:480-434-3251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ283446363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health